INFLUENCE OF A NOVEL AMINO-ACID SOLUTION (ENRICHED WITH THE DIPEPTIDEGLYCYL-TYROSINE) ON PLASMA AMINO-ACID CONCENTRATION OF PATIENTS WITH ACUTE-RENAL-FAILURE

In this randomized, double-blind controlled study we compared the effe ct of parenteral nutrition with two different amino acid solutions on the plasma concentration of amino acids in 27 patients with acute rena l failure. Fourteen patients received the new dipeptide-containing (gl ycyl-tyrosine) amino acid solution (AADI) in combination with glucose (60%) and fat (10%) as an 'all-in-one' solution over 120 h continuousl y via a central venous catheter. In the control group (AAST), parenter al nutrition with a standard amino acid solution in isonitrogenous and isocaloric form (0.7 g amino acids/kg BW/day and 25 kcal/kg BW/day) w as administered to 13 patients over the same period of time. The admin istration of the dipeptide-containing amino acid solution caused a ret urn to within the normal range of most of the amino acid concentration s which were decreased at the onset. A significant difference could be found between the AADI and AAST group for the achieved plasma concent rations of threonine (P<0.01), phenylalanine (P<0.05), isoleucine (P<0 .05), tryptophan (P<0.01) and ornithine (P<0.05). The phenylalanine/ty rosine ratio, did not change in the AADI group, while a marked increas e was observed in the AAST group. (152.7 +/- 23.5 - 159.8 +/- 37.6 vs 172.6 +/- 24.6 - 310.6 +/- 136.7, respectively). The plasma concentrat ion of glycyl-tyrosine was at the limit of detectability indicating ra pid hydrolysis of the dipeptide in acute renal failure. These data sug gest that the new dipeptide-containing amino acid solution offers a cl ear advantage over a standard amino acid formulation in correcting the amino acid imbalances in plasma of patients with ARF and is able to m aintain normal tyrosine concentrations and phenylalanine/tyrosine rati o.