Oral supplementation of branched-chain amino acid improves nutritional status in elderly patients on chronic haemodialysis

Nephrol Dial Transplant. 2001 Sep;16(9):1856-62. doi: 10.1093/ndt/16.9.1856.


Background: Anorexia may be associated with decreased plasma levels of branched-chain amino acids (BCAA). In malnourished elderly haemodialysis (HD) patients, oral BCAA supplementation may improve anorexia, resulting in improved nutritional status.

Methods: Among 44 elderly (age >70 years) patients on chronic HD, 28 patients with low plasma albumin concentration (<3.5 g/dl) were classified as the malnourished group; they also suffered from anorexia. The other 16 patients did not complain of anorexia and were classified as the well-nourished group. We performed a 12-month, placebo-controlled, double-blind study on the malnourished group. Fourteen patients each received daily oral BCAA supplementation (12 g/day) or a placebo in random order in a crossover trial for 6 months. Body fat percentage, lean body mass, plasma albumin concentration, dietary protein and caloric intakes, and plasma amino acid profiles were monitored.

Results: Lower plasma levels of BCAA and lower protein and caloric intakes were found in the malnourished group as compared to the well-nourished group. In BCAA-treated malnourished patients, anorexia and poor oral protein and caloric intakes improved within a month concomitant with the improvement in plasma BCAA levels over the values in well-nourished patients. After 6 months of BCAA supplementation, anthropometric indices showed a statistically significant increase and mean plasma albumin concentration increased from 3.31 g/dl to 3.93 g/dl. After exchanging BCAA for a placebo, spontaneous oral food intake decreased, but the favourable nutritional status persisted for the next 6 months. In 14 patients initially treated with a placebo, no significant changes in nutritional parameters were observed during the first 6 months. However, positive results were obtained by BCAA supplementation during the subsequent 6 months, and mean plasma albumin concentration increased from 3.27 g/dl to 3.81 g/dl.

Conclusions: Normalization of low plasma levels of BCAA by oral supplementation can reduce anorexia and significantly improve overall nutritional status in elderly malnourished HD patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Amino Acids, Branched-Chain / administration & dosage*
  • Amino Acids, Branched-Chain / adverse effects
  • Amino Acids, Branched-Chain / blood
  • Amino Acids, Branched-Chain / therapeutic use
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Nutrition Disorders / drug therapy
  • Nutrition Disorders / etiology
  • Nutrition Disorders / physiopathology
  • Nutritional Status / drug effects*
  • Renal Dialysis* / adverse effects
  • Time Factors


  • Amino Acids, Branched-Chain