Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 556925
Title Tryptophan intake and tryptophan losses in hemodialysis patients : A balance study
Author(s) Post, Adrian; Huberts, Marleen; Poppe, Enya; Faassen, Martijn van; Kema, Ido P.; Vogels, Steffie; Geleijnse, Johanna M.; Westerhuis, Ralf; Ipema, Karin J.R.; Bakker, Stephan J.L.; Franssen, Casper F.M.
Source Nutrients 11 (2019)12. - ISSN 2072-6643
DOI https://doi.org/10.3390/nu11122851
Department(s) VLAG
Nutrition and Disease
Publication type Refereed Article in a scientific journal
Publication year 2019
Keyword(s) Dialysis - Dietary diaries - Excretion - Hydroxyindoleacetic acid - Kynurenine - Tryptophan
Abstract

Tryptophan depletion is common in hemodialysis patients. The cause of this depletion remains largely unknown, but reduced nutritional tryptophan intake, losses during dialysis or an increased catabolism due to an inflammatory state are likely contributors. Currently, little is known about tryptophan homeostasis in hemodialysis patients. We assessed dietary tryptophan intake, measured plasma tryptophan during dialysis, and measured the combined urinary and dialysate excretion of tryptophan in 40 hemodialysis patients (66 ± 15 years and 68% male). Patients had low tryptophan concentrations (27 ± 9 µmol/L) before dialysis. Mean dietary tryptophan intake was 4454 ± 1149 µmol/24 h. Mean urinary tryptophan excretion was 15.0 ± 12.3 µmol/24 h, dialysate excretion was 209 ± 67 µmol/24 h and combined excretion was 219 ± 66 µmol/24 h, indicating only 5% of dietary tryptophan intake was excreted. No associations were found between plasma tryptophan concentration and tryptophan intake, plasma kynurenine/tryptophan ratio or inflammatory markers. During dialysis, mean plasma tryptophan concentration increased 16% to 31 ± 8 µmol/L. Intradialytic increase in plasma tryptophan was associated with a lower risk of mortality, independent of age, sex and dialysis vintage (HR: 0.87 [0.76–0.99]; P = 0.04). Tryptophan intake was well above the dietary recommendations and, although tryptophan was removed during dialysis, mean plasma tryptophan increased during dialysis. The cause of this phenomenon is unknown, but it appears to be protective.

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