Amino acid metabolism, substrate availability and the control of protein dynamics in the human kidney

The mechanisms controlling protein metabolism in the human kidney are not well understood. During adult life, kidney protein content and the size of the kidney remain fairly constant, indicating that protein synthesis and degradation within the kidney are tightly regulated. However, kidney protein turnover may change in response to stimuli such as alterations in substrate availability, hormones or growth factors, acid-base balance, renal work or renal injury with a progressive decrease in the number of nephrons. These factors have been evaluated mainly in animals, in vitro or in vivo. Amino acids, the kidneys substrates for protein synthesis, are provided by several routes. Like in other organs, amino acids can reach the kidney cells through the arterial blood flow. However, they may also come from the degradation of reabsorbed low-molecular weight proteins filtered by the glomerulus. The human kidney has high rates of protein turnover and leucine oxidation. The magnitude of the protein turnover across the human kidney suggests that the protein dynamics is partly determined by intrarenal protein catabolism. As evaluated by a steady-state leucine multiple compartment analysis, kidney protein synthesis is dependent to a similar extent on intrarenal generation of amino acids from protein breakdown and from amino acids taken up from the arterial blood. Kidney mass may therefore depend not only on the availability of free amino acids, but also on filtered proteins which are degraded within the kidney. Future studies could define the mechanisms, metabolic pathways and mediators influencing kidney protein turnover in humans, with a view to better comprehension of the mechanisms of disease.