Altered Amino Acid Metabolism in Patients with Cardiorenal Syndrome Type 2: Is It a Problem for Protein and Exercise Prescriptions?

• Main Authors: Roberto Aquilani, Roberto Maestri, Maurizia Dossena, Maria Teresa La Rovere, Daniela Buonocore, Federica Boschi, Manuela Verri
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Nutrients
• Subjects: cardiorenal syndrome; plasma amino acids; multiorgan impact; practical implications
• Online Access: https://www.mdpi.com/2072-6643/13/5/1632

The goal of this retrospective study was to document any alterations in plasma amino acids (AAs) in subjects with cardiorenal syndrome type 2 (CRS 2). We analyzed data from sixteen patients with CRS 2 and eight healthy subjects (control group, C), whose plasma arterial (A) and venous (V) AA concentrations had been measured. Compared to C, the group of CRS 2 patients showed significant reductions by more than 90% in A (<i>p</i> < 0.01) and V (<i>p</i> < 0.01) individual AAs, whereas negative A-V differences that indicated a net muscle AA release (muscle hypercatabolism) were found in 59% of CRS 2 patients (<i>p</i> < 0.03). No significant differences in plasma A and V AA concentrations nor in A-V differences were found between patients with mild kidney damage (<i>N</i> = 5; estimated glomerular filtration rate, eGFR ≥ 60 mL/min/1.73 m²) and patients with moderate-severe kidney damage (<i>N</i> = 11; eGFR < 60 mL/min/1.73 m²). Several plasma arterial AAs correlated with hemodynamic variables, but not with GFR. The study showed that patients with CRS 2 had very low concentrations of circulating AAs, independent of the degree of GFR damage.