Beneficial effect of essential amino acid therapy on diabetic renal failure.

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  • 糖尿病性腎症による腎不全に対する必須アミノ酸療法の有効性の検討

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To evaluate the efficacy of the essential amino acids (EAA) on diabetic renal failure, 18 diabetic patients associated with renal failure were studied retrospectively and divided into the following 3 groups; 1) EAA-nontreated group (n=6), 2) EAA-effective group (n=4), 3) EAA-noneffective group (n=8). Their ages and duration of diabetes were mutually comparable. EAA supplementation consisted of 6.3-12.6g of oral or intravenously administered EAA, accompanied by a diet including 40-50g of protein and 1, 500-1, 800 calories a day.<BR>Comparison of clinical data at the start of the EAA therapy revealed significant differences only in BUN and serum creatinine (SCr) between the EAA-effective and-noneffective groups. The level of BUN and SCr were 53±13.6 mg/dl and 3.6±1.3 mg/dl in EAA-effective group. In EAA-noneffective group the respective levels were 69±7.1 mg/dl and 6.9±1.9 mg/dl.<BR>The progression of renal failure in the 3 groups was analyzed by comparing the slopes of the regression lines of the reciprocal of SCr (1/SCr) over time. After EAA therapy, the slope of the regression line became significantly less in the EAA-effective group but not in the EAA-noneffective and-nontreated groups. However 2 years prior to EAA therapy in the EAA-noneffectivc group and at 2 years prior to the stage of SCr over 5.0 mg/dl in EAA-nontreatcd group the 1/SCr slope In as less than 0.5, but in the EAA-effective group it was more than 0.5.<BR>These results indicate that EAA therapy is no longer effective for diabetic renal failure after the SCr exceeds 5.0 mg/dl, and that EAA therapy may be initiated when SCr exceeds 2.0 mg/dl to alleviate the progression of diabetic renal failurc

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