Keywords: Hemodialysis, muscle, protein, physical activity

"Supporting muscle maintenance in patients undergoing hemodialysis"

The kidneys are two important organs of the human body. In advanced chronic kidney disease, renal filtration is insufficient to adequately remove metabolic waste products and fluids from the body. In these patients, metabolic waste products have to be removed artificially, which is often done by hemodialysis.

Patients undergoing hemodialysis generally have low muscle mass and muscle strength. This thesis reports that the removal of amino acids during hemodialysis contributes substantially to protein malnutrition in these patients. Patients can fully compensate for amino acid removal by ingesting ample protein, preferably in combination with physical activity, during hemodialysis. In addition, this thesis shows that protein ingestion during hemodialysis does not attenuate hemodialysis efficacy. Co-ingesting ketoacids with protein during hemodialysis enhances the anabolic properties of dietary protein.

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