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Effects of feeding on albumin synthesis in hypoalbuminemic hemodialysis patients

Lookup NU author(s): Dr Jonathan Louden, Professor Kim Bartlett, Dr David Reaich, Professor Tim Goodship


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Background. Hypoalbuminemia is a powerful predictor of morbidity and mortality in hemodialysis (HD) patients and results from a reduction in albumin synthesis, It is not known if this is associated with any impairment of the normal response to feeding. Methods. Protein turnover and albumin synthesis were measured in the fasting and fed state using a primed constant infusion of L-[1-C-13]leucine in seven hypoalbuminemic (albumin less than or equal to 36 g/L) HD patients (HHD), seven normoalbuminemic (albumin greater than or equal to 40 g/L) HD patients (NHD) and nine age-matched normal controls. Results. The increase in albumin synthesis on feeding was impaired in HHD patients (fasting 15.0 +/- 1.5 vs. fed 17.7 +/- 2.9%, P = NS) compared to NHD (fasting 13.7 +/- 0.9 vs. fed 17.4 +/- 1.0%, P < 0.05) and controls (fasting 12.9 +/- 0.6 vs. fed 15.2 +/- 0.6%. P < 0.05). In addition. body mass index and percent body fat were significantly (P < 0.05) lower in HHD (20.8 +/- 1.3 kg/m(2), 23.4 +/- 2.0%) than NHD (26.7 +/- 1.3 kg/m(2), 33.1 +/- 3.2%) or controls (26.2 +/- 1.1 kg/m(2). 32.6 +/-1.8%), There was no difference in dietary protein or energy intake in the three groups. Conclusions. There are differences of body composition and protein metabolism in HHD patients that may be related to an impaired metabolic response to feeding.

Publication metadata

Author(s): Bartlett K; Reaich D; Goodship THJ; Louden JD; Edson R; Alexander C

Publication type: Article

Publication status: Published

Journal: Kidney International

Year: 2002

Volume: 62

Issue: 1

Pages: 266-271

ISSN (print): 0085-2538

ISSN (electronic): 1523-1755

Publisher: Nature Publishing Group


DOI: 10.1046/j.1523-1755.2002.00413.x


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