Effects of an amino acid dialysate on leucine metabolism in continuous ambulatory peritoneal dialysis patients

Kidney Int. 1999 Nov;56(5):1934-43. doi: 10.1046/j.1523-1755.1999.00723.x.


Background: Protein-energy malnutrition is frequent in continuous ambulatory peritoneal dialysis (CAPD) patients. The use of amino acids in the dialysate could improve the protein balance, especially if associated to a concomitant energy intake.

Methods: A 1.1% amino acid solution for peritoneal dialysis was administered to CAPD patients over 30 minutes during concomitant absorption of 600 ml water (control study) or of a 600 kcal meal/600 ml. Leucine metabolism was studied using the combination of intravenous [2H3] and intraperitoneal [13C] leucine.

Results: The rate of leucine appearance was stimulated by 56 and 53% (control and meal) at 45 minutes. The rates of leucine appearance and disappearance were lower from 180 to 300 minutes during the meal versus control study (P < 0.05). Proteolysis was unaffected during the control study and was inhibited by 25% during the meal study (P < 0.05). During the five-hour cycle dialysis with or without a meal, 80% of the leucine administered into the peritoneum was absorbed. Forty-one percent was retained in the splanchnic bed. Forty-three percent was used for protein synthesis, and 16% was oxidized.

Conclusions: This amino acids solution is efficaciously utilized for protein synthesis in CAPD patients with no effect on protein breakdown. The concomitant ingestion of a carbohydrate-lipid meal inhibits protein breakdown and reinforces a positive effect of the amino acids solution on protein balance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amino Acids / pharmacology*
  • Blood Glucose / analysis
  • Carbohydrate Metabolism
  • Female
  • Humans
  • Leucine / metabolism*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Respiration


  • Amino Acids
  • Blood Glucose
  • Leucine