The effects of calorie and essential amino acid supplementation on plasma proteins in patients with chronic renal failure,

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Abstract
Ten plasma proteins, the packed cell volume and serum urea were determined in 12 patients with chronic renal failure who were receiving 30 g of dietary protein plus 2000 cal per day for 4 weeks and in 12 normal individuals. Seven patients received an additional 400 cal during a 2nd month and also during the 3rd month when oral essential amino acids plus tyrosine (1 g of nitrogen per day) were added to the diet. Calorie supplementation alone did not produce any consistent changes, but when combined with essential amino acids there was a significant increase in plasma transferrin, prealbumin, and albumin and, for five patients, in β-lipoprotein and cholinesterase. During the month after the supplements were stopped, concentrations of most proteins were maintained above the presupplementation values. Dietary changes had no significant effect on α2-macroglobulin, α1-antitrypsin, α1-antichymotrypsin, ceruloplasmin, packed cell volume, or urea. An evaluation of 20 proteins measured in this and previous investigations shows that several proteins, and particularly transferrin, are useful for the assessment of nutritional status. In addition, certain proteins, such as prealbumin, β-lipoprotein, and cholinesterase, can be used for monitoring the effect of changes in dietary therapy. It is concluded that essential amino acid supplements are utilized for protein synthesis in most patients on low protein diets with a minimal increase in urea production.