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Muscle and plasma amino acids and nutritional status in kidney-transplanted children
F Perfumo1, A Canepa, J C Divino Filho
1Nephrology Department, Istituto Giannina Gaslini, Genova, Italy.
Insights
Kidney transplant recipients showed normal muscle composition but altered plasma amino acid levels, potentially linked to prednisone treatment. These findings suggest specific nutritional monitoring for pediatric transplant patients.
Area of Science:
- Pediatric Nephrology
- Nutritional Biochemistry
- Transplantation Medicine
Background:
- Assessing nutritional status is crucial in pediatric kidney transplant recipients.
- Understanding post-transplant metabolic changes aids in optimizing patient care.
- Previous studies have not fully elucidated muscle and plasma amino acid profiles in this population.
Purpose of the Study:
- To evaluate the nutritional status, muscle composition, and amino acid profiles in children following kidney transplantation.
- To compare these parameters with a control group of healthy children undergoing surgery.
- To investigate potential correlations between observed changes and immunosuppressive therapy.
Main Methods:
- Anthropometric and biochemical assessments were performed on 11 kidney transplant recipients and 10 controls.
- Muscle (rectus abdominis) and plasma samples were analyzed for protein, water, DNA, and amino acid content.
- Time from transplantation to study was approximately 97 days.
Main Results:
- Transplanted children had reduced height but normal serum proteins and body mass index above the 50th percentile in most cases.
- Muscle composition (total water, protein, DNA) was comparable between transplanted and control groups.
- Significant alterations in plasma amino acids (decreased leucine, taurine; increased citrulline, alanine) and muscle amino acids (increased threonine, alanine, glycine) were observed in transplant recipients.
Conclusions:
- Pediatric kidney transplant recipients exhibit a largely normal muscle amino acid profile.
- Plasma amino acid patterns in these patients may be influenced by prednisone therapy.
- Further research is warranted to understand the clinical implications of these biochemical changes.
Abstract:
Nutritional status, assessed by anthropometric and biochemical methods, protein and amino-acid (AA) composition and muscle water were evaluated in 11 kidney transplanted children and in a control group of 10 children with normal renal function who were undergoing elective surgery. Samples of the rectus abdominis muscle were taken when surgery was performed in the control children and when the peritoneal catheter was removed in the transplanted children. The mean time from the transplantation to the study time was 97 +/- 14 days (range 72-114 days). Height was reduced in the transplanted children compared to the controls but skinfold thickness, arm muscle circumference and serum proteins (total protein, albumin, transferrin, pseudocholinesterase) were normal. The body mass index was over the 50 degree percentile in nine of the eleven children. The muscle contents of total, extracellular, and intracellular water, alkali-soluble protein (ASP), DNA and the ASP/DNA ratio were not significantly different in transplanted children from those in the controls. Plasma leucine and taurine levels were significantly decreased, whereas plasma citrulline and alanine levels and the glycine/serine ratio were increased. Muscle threonine, alanine+taurine, glycine and aspartic acid levels as well as the glycine/serine ratio were increased in the transplanted children. Transplanted children show an almost normal muscle AA profile and a plasma AA pattern that seems to be related to the prednisone therapy.