CORRECTION OF ACIDOSIS IN CAPD DECREASES WHOLE-BODY PROTEIN-DEGRADATION

Correction of acidosis in CAPD decreases protein degradation and synth esis but has no effect on leucine oxidation. The effect of the correct ion of metabolic acidosis in CRF patients treated with CAPD was determ ined from the kinetics of infused L-[1-C-13]leucine. Seven CAPD patien ts were studied before (acid) and after correction of acidosis (bicarb onate) (pH: acid 7.39 +/- 0.01, bicarbonate 7.41 +/- 0.01, P = 0.005). Leucine appearance from body protein (PS) and leucine disappearance i nto body protein (PD) decreased significantly with correction of acido sis. (PS: acid 211.7 +/- 9.8, bicarbonate 142.3 +/- 4.2 mu mol . kg(-1 ). hr(-1), P < 0.001; PD: acid 200.6 +/- 8.5, bicarbonate 132.4 +/- 3. 7 mu mol . kg(-1). hr(-1), P < 0.001). There was no significant change in leucine oxidation or plasma amino acid concentrations. These resul ts demonstrate that optimal correction of acidosis in CAPD is benefici al in terms of protein turnover.