Abstract
To evaluate the efficacy of the essential amino acids (EAA) on diabetic renal failure, 18 diabetic patients associated with renal failure were studied retrospectively and divided into the following 3 groups; 1) EAA-nontreated group (n=6), 2) EAA-effective group (n=4), 3) EAA-noneffective group (n=8). Their ages and duration of diabetes were mutually comparable. EAA supplementation consisted of 6.3-12.6g of oral or intravenously administered EAA, accompanied by a diet including 40-50g of protein and 1, 500-1, 800 calories a day.
Comparison of clinical data at the start of the EAA therapy revealed significant differences only in BUN and serum creatinine (SCr) between the EAA-effective and-noneffective groups. The level of BUN and SCr were 53±13.6 mg/dl and 3.6±1.3 mg/dl in EAA-effective group. In EAA-noneffective group the respective levels were 69±7.1 mg/dl and 6.9±1.9 mg/dl.
The progression of renal failure in the 3 groups was analyzed by comparing the slopes of the regression lines of the reciprocal of SCr (1/SCr) over time. After EAA therapy, the slope of the regression line became significantly less in the EAA-effective group but not in the EAA-noneffective and-nontreated groups. However 2 years prior to EAA therapy in the EAA-noneffectivc group and at 2 years prior to the stage of SCr over 5.0 mg/dl in EAA-nontreatcd group the 1/SCr slope In as less than 0.5, but in the EAA-effective group it was more than 0.5.
These results indicate that EAA therapy is no longer effective for diabetic renal failure after the SCr exceeds 5.0 mg/dl, and that EAA therapy may be initiated when SCr exceeds 2.0 mg/dl to alleviate the progression of diabetic renal failurc
