Improved plasma amino acids pattern following 12 months of supplemented low-protein diet in peritoneal dialysis patients.

Background: Decreased plasma essential amino acid (EAA) levels, increased nonessential amino acid (NEAA) levels, and low EAA to NEAA ratio (E/NEAA) are common in peritoneal dialysis (PD) patients and may impact uremic complications. In the present study, we investigate the impact of keto acids–supplemented low–protein (sLP) diet on plasma amino acids (AAs) patterns in stable PD patients. Methods: This is a supplemental analysis of a previously published prospective and randomized trial. Thirty-nine PD patients selected from the original population were divided to receive either low (LP: 0.6–0.8 g/kg ideal body weight [IBW]/d, n = 13), keto acids–supplemented low- (sLP: 0.6–0.8 g/kg IBW/d + 0.12 g/kg IBW/d of keto acids, n = 12), or high- (HP: 1.0–1.2 g/kg IBW/d, n = 14) protein diets and followed for 1 year. Plasma AA patterns were assessed at baseline and 12 months using high-performance liquid chromatography. Results: Whereas there were no significant differences between the three groups at baseline, following 12 months, the E/NEAA had increased significantly in group sLP (0.58 ± 0.16 to 0.83 ± 0.20, p < 0.05), but was not different in either LP (0.62 ± 0.20 to 0.72 ± 0.13, p = ns) or HP (0.66 ± 0.14 to 0.74 ± 0.12, p = ns) group. This change in E/NEAA in group sLP was due to a significant decrease in NEAA concomitantly with maintained EAA levels, whereas in the other two groups, neither EAA nor NEAA changed significantly. Conclusions: A low-protein diet supplemented with keto acids significantly improved the pattern of plasma AA in prevalent PD patients. [ABSTRACT FROM AUTHOR]