Oral essential amino acid supplementation in patients on maintenance hemodialysis

Sixteen patients with chronic renal failure on maintenance hemodialysis were studied before and during oral treatment with essential amino acids. The patients received their usual diets (60-100 g protein/day) throughout the study. Plasma amino acids were studied pre-dialysis before supplements were started, after one month and after three months treatment; some measurements were also carried out post-dialysis. Before treatment 63% of patients pre-dialysis, and 82% post dialysis, had at least one essential amino acid value which was lower than our normal range. After one month of treatment 38% of patients pre-dialysis, and 67% post-dialysis, had one or more low essential amino acid value. After 3 months only 2 patients had an abnormal essential amino acid chromatogram pre-dialysis. Changes in non-essential amino acids, blood urea, serum proteins and hemoglobin are also reported. The data show that low plasma essential amino acid concentrations are frequently present in patients on maintenance hemodialysis even when the diet contains theoretically adequate amounts of protein. This deficiency can be corrected successfully with oral essential amino acid supplements.