Histidine and iron supplementation in dialysis and pre-dialysis patients

Chronic renal failure (CRF) patients treated with histidine alone did not show any effect with respect to anaemia or protein metabolism, despite a rise in serum histidine levels. Beneficial effect of iron with regards to anaemia and protein metabolism was seen in CRF patients treated with iron alone or in combination with histidine. Patients with combination therapy showed accelerated improvement of anaemia in comparison with patients treated with iron alone. In RDT patients, who underwent basic treatment with parenteral iron, histidine failed to show any effect with regards to anaemia, despite significantly lowered serum histidine levels. But under histidine treatment a significant rise of transferrin levels occurred in RDT patients, so that histidine must be considered as a limiting factor in protein metabolism in these cases. Histidine requirements of RDT patients are more than 1-2 g/day, and are higher than the requirements of patients conservatively treated.