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Paul F. Gulyassy, MD; Alexander Aviram, MD; John H. Peters, PhD

Arch Intern Med. 1970;126(5):855-859.

Abstract
Plasma amino acids were found to deviate extensively from normal in patients with end-stage uremia. Concentrations of all essential amino acids except phenylalanine and methionine were reduced. Progressive impairment of reabsorption of amino acids by the kidney is found as glomerular filtration rate (GFR) falls, renal clearances increasing fivefold to fortyfold at GFR less than 10 ml/min. Impairment of absorption of amino acids by the small intestine may explain the abnormal plasma curves after oral loading with tryptophan. These and other abnormalities may be the basis for development of abnormal protein metabolism in chronic, progressive renal failure in man.

Author Affiliations
San Francisco; Menlo Park, Calif

From the University of California Medical Services, San Francisco General Hospital and Northern California Artificial Kidney Center, (Drs. Gulyassy and Aviram), and the Life Sciences Division of Stanford Research Institute, Menlo Park, Calif (Dr. Peters).

Footnotes
Received for publication July 8, 1970; accepted July 16.

Read before the session entitled "Nitrogen Metabolism" (Carmelo Giordano, MD, chairman) of the Symposium on Uremic Toxins sponsored by the National Institute of Arthritis and Metabolic Diseases, Monterey, Calif, March 19,1970.

Reprint requests to San Francisco General Hospital, Room 350, Bldg 100, San Francisco 94110 (Dr. Gulyassy).

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