Nutrition and Muscle Catabolism in Maintenance Hemodialysis: Does Feeding Make Muscle Cells Selective Self-Eaters?

• Type of Material: Article
• Authors: Harold A. Franch, Emory University
• Language: English
• Date: 2009-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1053/j.jrn.2008.10.009
• Title of Journal or Parent Work: Journal of Renal Nutrition
• ISSN: 1051-2276
• Volume: 19
• Issue: 1
• Research Categories: Health Sciences, Nutrition

Abstract

Efforts to build muscle by increased protein feeding in hemodialysis patients have been thwarted by parallel increases in both muscle protein synthesis and degradation. The evidence suggests that muscle cells replace older proteins in response to feeding rather than using new proteins to drive muscle cell hypertrophy. This review presents the hypothesis that protein feeding provides an opportunity for muscle to accelerate proteolysis of proteins which have been damaged by oxidation, nitrosylation and/or glycosylation and to replace damaged mitochondria that contribute to oxidative stress. Increases in proteolysis with feeding are driven by insulin resistance and the increased oxidative stress of mitochondrial respiration. Oxidized proteins and organelles are excellent substrates for degradation by the proteasome, macroautophagy, and chaperone-mediated autophagy: these systems of proteolysis seem to be activated by oxydatiative stress. Replacement of oxidized and other damaged proteins may be a benefit of protein feeding in hemodialysis, but alternative strategies, including exercise, will be required to build muscle.