The Effect of Dietary Glucose Polymer Supplementation on the Nutrition and Plasma Amino Acids of Hemodialysis Patients
Patients undergoing maintenance hemodialysis frequently have plasma amino acid profile abnormalities. The concentrations of essential amino acids may be below the normal range. Because this pattern has similarities with that found in protein-energy malnutrition, it has been postulated that poor nutrition is contributing to the abnormalities. Since the most limiting nutrient in the diet of hemodialysis patients is likely to be energy, 10 patients (supplemented = 5, nonsupplemented = 5) were entered in a trial of energy supplementation using 100 to 150 g/d glucose polymer for 6 months. The impact of supplementation on dietary intake, weight, body fat, calculated lean body mass, plasma proteins, and plasma amino acids was determined. After supplementation, energy intake, weight, and body fat increased; however, the only change in plasma amino acids was an increase in plasma tryptophan. Factors other than energy deficit are implicated in the etiology of plasma amino acid deficits, but further studies to determine the use of tryptophan to monitor changes in nutritional status are indicated.