The effect of dietary protein restriction or treatment with an angiotensin converting enzyme inhibitor on protein metabolism as reflected by plasma amino acid levels and nitrogen balance was determined in 12 patients with the nephrotic syndrome. During the control period (protein intake 1.6 g/kg per day), the mean values for hydroxyproline, glutamic acid, citrulline and 3-methylhistidine were greater than and those of cystine and tryptophan were less than the range of values (mean ± two standard deviations of the mean) in normal subjects. A significant inverse correlation between the plasma levels of citrulline and 3-methylhistidine and the average values of creatinine clearance was noted. However, there was no significant correlation between creatinine clearance and the other plasma amino acid levels. Similarly, there was no correlation between the degree of proteinuria and the plasma amino acid levels. Neither treatment with enalapril nor reduction in dietary protein intake (0.8 g/kg per day) significantly altered the plasma amino acid profile. Reducing dietary protein intake decreased, while treatment with enalapril increased nitrogen balance, although neither of these changes achieved a level of statistical significance. Thus, neither moderate dietary protein restriction nor treatment with angiotensin converting enzyme inhibitors over a three week period has an apparent untoward effect on protein metabolism in patients with the nephrotic syndrome.
|Original language||English (US)|
|Issue number||SUPPL. 27|
|State||Published - 1989|
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