AL Ternate Use of Amino Acid and Glucose Solutions in CAPD

For three months we alternately used CAPD solutions based on amino acids or glucose in six patients. At the start, amino acid concentrations in plasma (P) were normal, except that for leucine which was low and citrulline was high. During the study, P-valine, -isoleucine, -leucine, and -serine increased while the concentration of methionine decreased. The increase in the plasma concentration of the three branched-chain amino acids might increase protein synthesis; leucine particularly assists protein synthesis in muscle. However the technical and analytical methods used in this investigation do not permit us to draw such conclusions. Serum concentrations of cholesterol, HDL, LDL, glucose and glycosylated hemoglobin remained unchanged, as did concentrations of albumin, transferrin, and phosphate. The nitrogen load from amino acids did not increase the plasma ammonium concentration, while serum urea increased slightly. Serum triglycerides continued to increase in spite of the amino acid supplementation. Thus the amino acid solution, which was well tolerated, seemed to induce some beneficial alterations in the plasma amino acid concentrations in the uremic patient. The consequence of these changes remains to be evaluated.