Metabolic conversion of alpha-keto valine to valine in patients with chronic renal failure

Change in the metabolic conversion rate of alpha-keto valine to valine following oral administration of the analog of the essential amino acid (0.1 g/kgB.W.) is studied in six patients with chronic renal failure and five control subjects under low protein, low and normal energy intake diets. Diet I is composed of 105 kj (25 kcal)/kgB.W. energy and 0.6 g/kgB.W. protein, whereas Diet II is composed of 165 kj (40 kcal)/kgB.W. with the same amount of protein intake. As a result, an increase in plasma keto valine concentration is observed immediately after oral administration, followed by an increase in plasma valine concentration, implying that metabolic conversion of alpha-keto valine to valine occurs within a small amount of time. In addition, the conversion rate appears to be accelerated under Diet II. It is therefore suggested that reutilization of urea nitrogen with the ketoanalog under the low protein diet seems to be promoted under adequate energy intake.