Abstract
【Objectives】 To investigate the efficacy of pharmaceutically manufactured oral essential amino acids (EAA) for improving the serum amino acid profiles and nutritional indexes of hemodialysis patients. 【Subjects】 Thirty-four patients who fulfilled the following entry criteria : undergoing hemodialysis or hemodiafiltration three times a week for >1 year, 3.0 g/dL≤serum albumin<3.8 g/dL, and an estimated daily calorie intake of ≥25 kcal/kg. Patients that met the following criteria were excluded from the study : advanced hepatic failure, C-reactive protein level of ≥2.0 mg/dL, a pre-dialysis HCO3 level of <16 mEq/L, a glycated hemoglobin level of >6.5%, or a body mass index of <18 kg/m2. 【Methods】 A series of blood tests were performed prior to the commencement of the oral EAA therapy, and at 1, 2, and 3 months after the start of therapy. The patients’ serum amino acid profiles were assessed before and 3 months after treatment. 【Results】 The mean EAA level increased from 844.1±159.4 nmol/mL to 868.0±222.9 nmol/mL. The mean non-essential amino acid (NEAA) level decreased from 2278.2±464.5 nmol/mL to 2053.6±356.7 nmol/mL (p<0.01). The mean EAA : NEAA ratio increased from 0.38±0.07 to 0.44±0.08 (p<0.01). The mean branched chain amino acid (BCAA) level increased from 337.8±94.0 nmol/mL to 378.3±96.3 nmol/mL. The mean BCAA : total amino acids ratio increased from 0.11±0.02 to 0.13±0.02 (p<0.01). The mean 3-methylhistidine level decreased from 24.3±5.6 nmol/mL to 22.5±5.1 nmol/mL (p<0.05). The mean serum albumin level increased to 3.51 g/dL after 3 months and remained stable thereafter in patients whose serum albumin levels were <3.5 g/dL before the start of therapy (p=0.156). 【Conclusion】 The oral administration of EAA improved the serum amino acid profiles of hemodialysis patients and might be an effective therapy for treating malnutrition in such patients.
