Muscle Protein Synthesis in Dialysis Patients

Completed

Conditions studied: Muscle Loss

In brief

The most severe form of chronic renal failure is end-stage-renal-disease with maintenance hemodialysis (MHD) as the most common treatment strategy. MHD patients experience a number of metabolic and phenotypic derangements including skeletal muscle wasting. Previously, it has been demonstrated that dialysis treatment leads to increased rates of forearm phenylalanine uptake (proxy for 'muscle' protein synthesis) with an even greater rates of phenylalanine release (proxy for 'muscle' protein breakdown). Hence, the dialysis procedure itself is catabolic and induces a catabolic carryover for several hours after dialysis. This suggests prolonged post-dialysis disturbances in whole body- and skeletal muscle protein metabolism in MHD patients. Moreover, dialysis treatment in itself results in \~20 % losses of circulating amino acids in the dialysate. Collectively, this creates the need for replacement of amino acids by protein supplementation during and/or after dialysis. The ingestion of protein-dense meals in between dialysis treatments likely represents an important dietary strategy to counterbalance dialysis-induced catabolism and to achieve the current recommended protein intakes (set at 1.2 g/kg bodyweight/d) to limit muscle protein loss in MHD patients. However, the effectiveness of protein-rich meal ingestion to augment postprandial whole body and muscle protein metabolic responses in MHD patients outside of the dialysis period remain largely undefined. The purpose of this study is to compare basal and postprandial whole body leucine body kinetics, muscle anabolic sensing mechanisms, markers of muscle proteolysis, and myofibillar protein synthesis rates to mixed meal ingestion on a non-dialysis day in eight MHD patients, between 20-80 and to compare these outcomes to age- and BMI-matched controls. The investigators will use specifically produced intrinsically L-\[5,5,5-2H3\]leucine labeled eggs combined with primed constant amino acid tracer infusion methods and concomitant blood and muscle direct sampling to make direct assessments of in vivo protein digestion and absorption kinetics and subsequent postprandial muscle protein synthetic responses in MHD patents and controls. On the test day, subjects will remain sedentary for the determination of muscle protein synthesis in both the fasted state and after consumption of the meal.

Key facts

Study ID

NCT03478722

Run by

University of Illinois at Urbana-Champaign

People needed

16

Starts

2017-01-18

Expected to finish

2018-04-01

Last updated by the study team

2018-05-01

Who can join

Age: 20 and older, up to 80. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Aged 20-80 years (both healthy controls and MHD patients)
• Medical clearance from a Nephrologist at their respective dialysis clinic to participate (MHD patients)

You may not qualify if…

• Known allergies to egg consumption (both healthy controls and MHD patients)
• Phenylketonuria (both healthy controls and MHD patients)
• Vegans (both healthy controls and MHD patients)
• Diagnosed GI tract diseases (healthy controls)
• Recent (1 year) participation in amino acid tracer studies (both healthy controls and MHD patients)
• Predisposition to hypertrophic scarring or keloid formation (both healthy controls and MHD patients)
• Diabetes (healthy controls)
• Pregnancy (both healthy controls and MHD patients)

Where it is running

• Freer Hall — Urbana, Illinois, United States

Full record on ClinicalTrials.gov

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