Amino acid and alpha-keto acid metabolism of long-term hemodialysis patients depends from oxygene availability

Hemodialysis (HD) patients show renal anemia and malnutrition. This is refl ected by changed plasma amino acid levels. Our question was, how far malnut rition can be improved by rhEPO/iron supplementation therapy. Plasma levels of branched chain amino acids valine, leucine, isoleucine and their alpha- keto acids Served as markers for malnutrition. We compared plasma levels of 45 severe anemic HD patients (A) (Hb 7.2 +/- 0.8 [g/dl]), 34 partially cor rected (B) (Hb 10.3 +/- 0.6 [g/dl]), 35 totally corrected (C) (Hb 13.5 +/- 0.7 [g/dl]) patients and 60 healthy control persons (N) (Hb 14.2 +/- 1.1 [g /dl]), determined by fluorescence HPLC. In correlation to the hemoglobin co rrection plasma levels were improved significantly (p < 0.05 - 0.01): valin e (A/B/C/N): 130/146/155/205 (mu mol/l), leucine: 73/71/80/ 110 (mu mol/l) alpha-ketoisocaproate: 11.4/11.8/ 15.1/30.4 (mu mol/l). We conclude that im provement of energy metabolism follows so more, so better the correction of anemia happens. From this point of view we recommend the total correction of anemia in hemodialysis patients.