Hecking E, Köhler H, Zobel R, Lemmel E M, Mader H, Opferkuch W, Prellwitz W, Keim H J, Müller D
Am J Clin Nutr. 1978 Oct;31(10):1821-6. doi: 10.1093/ajcn/31.10.1821.
Patients on chronic hemodialysis may suffer from a latent protein deficiency, and therapy with essential amino acids has been recommended. In a double blind cross-over study, 13 hemodialysis patients received orally 15.7 g of essential amino acids daily over a 3-month period. Patients were on a liberal diet, containing 1 g of protein per kilogram of body weight per day. Hemodialysis was adequate. Therapy resulted in an increase in urea, uric acid, C3 c complement factor and a fall in C4. Lysine levels increased and phenylalanine fell. Malnutrition could not account for the observed metabolic changes, which are more likely due to uremic metabolic disturbances. A liberal diet of 1 g of protein per kilogram of body weight appears sufficient for patients on hemodialysis. Treatment with essential amino acids offers no advantage.
接受慢性血液透析的患者可能存在潜在的蛋白质缺乏，因此有人建议采用必需氨基酸疗法。在一项双盲交叉研究中，13名血液透析患者在3个月的时间里每天口服15.7克必需氨基酸。患者饮食自由，每天每公斤体重摄入1克蛋白质。血液透析充分。治疗导致尿素、尿酸、C3补体因子升高，C4降低。赖氨酸水平升高，苯丙氨酸水平降低。营养不良无法解释观察到的代谢变化，这些变化更可能是由于尿毒症代谢紊乱所致。对于血液透析患者来说，每天每公斤体重摄入1克蛋白质的自由饮食似乎就足够了。使用必需氨基酸治疗没有优势。
