Figure 189

Amino acid pools and amino acid utilization in acute renal failure (ARF). As a consequence of these metabolic alterations, imbalances in amino acid pools in plasma and in the intracellular compartment occur in ARF. A typical plasma amino acid pattern is seen [16]. Plasma concentrations of cysteine (CYS), taurine (TAU), methionine (MET), and phenylalanine (PHE) are elevated, whereas plasma levels of valine (VAL) and leucine (LEU) are decreased.

Moreover, elimination of amino acids from the intravascular space is altered. As expected from the stimulation of hepatic extraction of amino acids observed in animal experiments, overall amino acid clearance and clearance of most glucoplastic amino acids is enhanced. In contrast, clearances of PHE, proline (PRO), and, remarkably, VAL are decreased [16, 17]. ALA— alanine; ARG—arginine; ASN—asparagine; ASP—aspartate; CIT—citrulline; GLN—glutamine; GLU—glutamate; GLY— glycine; HIS—histidine; ORN—ornithine; PRO—proline; SER— serine; THR—threonine; TRP—tryptophan; TYR—tyrosine. (From Druml et al. [16]; with permission.)

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