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

Correction of acidosis in hemodialysis (HD) decreases protein degradat ion. The effect of the correction of chronic metabolic acidosis in chr onic renal failure patients treated with HD was determined from the ki netics of infused L-[1-C-13]leucine. Six HD patients were studied befo re (acid) and after (bicarbonate) correction of acidosis (pH: acid 7.3 6 +/- 0.01, bicarbonate 7.40 +/- 0.01, P < 0.005). Leucine appearance from body protein (PD) and leucine disappearance into body protein (PS ) decreased significantly with correction of acidosis (PD: acid 180.6 +/- 7.3, bicarbonate 130.9 +/- 7.2 mu mol . kg(-1). h(-1), P < 0.005; PS: acid 172.3 +/- 6.8, bicarbonate 122.0 +/- 6.8 mu mol . kg(-1). h(- 1), P < 0.005). There was no significant change in leucine oxidation o r plasma amino acid concentrations. These results demonstrate that opt imal correction of acidosis in HD is beneficial in terms of protein tu rnover and may improve long-term nutritional status in HD.