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American Journal of Clinical Nutrition, Vol 21, 394-404, Copyright © 1968 by The American Society for Clinical Nutrition, Inc.

Incorporation of Urea 15N in Amino Acids of Patients with Chronic Renal Failure on Low Nitrogen Diet

C. GIORDANO M.D.1, C. DE PASCALE M.D.1, C. BALESTRIERI PH.D.1, D. CITTADINI PH.D.1, and A. CRESCENZI PH.D.1

1 From the Institute of Internal Medicine and the Institute of Biochemistry, Naples University, Naples, Italy

The possibility of utilizing urea nitrogen for synthesis of nonessential amino acids in patients with chronic uremia on diets rich in essential amino acids was set forth in an earlier investigation. To test this hypothesis 15N urea was given to a normal subject and to a group of four patients with chronic renal failure.

The recovery of the isotope was attempted in all the component amino acids of plasma albumin and was found to be maximal in glutamic acid, alanine, aspartic acid, and serine but negligible in histidine, phenylalanine, methionine, threonine and tryptophan. On a low protein diet renal patients utilized urea two to three times more than the normal control. On an essential amino acid diet the utilization of urea was even more pronounced. Suppression of intestinal flora with Humatin greatly reduced urea utilization. The data provide support for the recommendation for treating patients with chronic uremia with diets low in nitrogen but rich in essential amino acids.




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