The renal clearance of 21 amino acids was investigated in 5 patients with chronic renal failure (inulin clearance ≈ 5–10ml/min) during the 6-week administration of a low-protein diet. The results were compared with values obtained in 6 volunteers. The renal clearance of all investigated amino acids (with the exception of Asp, His, Tau) did not differ significantly from healthy controls. The excretion fraction (amino acid clearance /inulin clearance 100) was in all investigated amino acids significantly higher than incontrols with the exception of Tau. The excretion fractions of Asp, Ser, Cys, Tyr, His, Thr, Tau and Gly were, on average, above 20%.The findings suggest that the fractional reabsorption of amino acids in residual nephrons is decreased.
A group of 17 patients with chronic renal impairment and a group of 11 patients surviving for 3-7 years after kidney transplantation were examined. In all patients plasma amino acids were analyzed. The ratio of essential/nonessential amino acids, the valine/glycine ratio and Whitehead’s quotient are influenced above all by the dietary protein intake. Raised citrulline and 3-methylhistidine values were not influenced by the protein intake, while they correlate with indicators of renal function. Changes detected after kidney transplantation are analogous.
In patients who had undergone gastric operations, the efficacy of a parenteral rehabilitation with plasma, human albumin and Amino-fusin® L forte was determined by assessing the extravascular albumin pool. The intravenous administration of Aminofusin® L forte thus proved to be today’s safest and quickest method of protein rehabilitation.
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