Accumulation of taurine in patients with renal failure

Description

Accumulation of taurine in patients with renal failure

Informations

• Publié par: idiqizof
• Nombre de lectures: 66
• Langue: English

Extrait

Table 1

Patient

Nephrol Dial Transplant (2002) 17: 528

Plasmammolul

Musclemmolul intracellular H 2 O

Before After10 weeksBefore After10 weeks

1 452481 15039 36053 2 96– 5600– 3 40712 915032 174 4 41– 9771– a a 27 controls49 (3)19 194(3378) a Mean (SD). Accumulation of taurine in patients with renal failure symptoms recurred. The study was then immediately stopped before any new patient had been recruited. Results of taurine analyses of plasma and muscle before and at the end of the Sir, study were available in patients 1 and 3 but only initial values The amino acid taurine (2-aminoethanesulphonic acid) is in patients 2 and 4, who withdrew from the study (Table 1). present in high concentrations in mammalian tissues, espe- Three of the patients were taurine-depleted with markedly cially skeletal muscle, heart and the central nervous system. reduced muscle taurine concentrations and one patient Taurine has several beneficial physiological and biochemical (patient 1) had a marginally low level compared to the con- effectsin vitroandin vivoin experimental animals. It has trols. After taurine treatment, the plasma levels in patients cardiotonic actions, participates in osmoregulation, stabilizes 1 and 3 had increased by 5513% and 1780%, respectively, and the membrane potential in skeletal muscle, affects calcium ion the muscle intracellular concentrations by 239% and 351%, kinetics, has antioxidant and anti-inflammatory properties respectively, i.e. far above the normal ranges. The accumula- and acts as a neurotransmitterw1x. Clinical studies suggest that tion of taurine was presumably due to lack of renal excretion, oral treatment with taurine improves symptoms and cardiac which in normal persons accounts for the excretion of excess performance in humans with congestive heart failurew2x. taurine. The removal by haemodialysis was apparently Taurine is an ingredient in some so-called energy drinks, insufficiently effective to control the body content of taurine. which also contain caffeine, carbohydrate and B vitamins. We conclude that the symptoms reported were caused by Such drinks are taken to improve physical performance, excessive extra- and intracellular accumulation of taurine. although there is little evidence that taurineper seexerts any In keeping with this conclusion is the observation that beneficial effects in healthy individuals or animals without withdrawal of taurine caused a rapid disappearance of the taurine depletion. It has been suggested that daily intake for 1 symptoms, which reappeared when one patient was rechal- 3 weeks of 0.5l Red Bull, providing 2 g of taurine and lenged with taurine after a symptom-free interval. 1.2 g of glucuronolacton, increasesendurance time slightly With this report we want to call attention to the risk of at maximum intensive exercise level, compared with drinks 1 taurine administration to patients with renal failure and containing the same ingredients as Red Bullbut without specially warn against the use of energy drinks such as Red glucuronolacton and taurinew3x. Hence, the effect might have 1 1 Bull and qBattery ,of which three cans of 33mluday been due to either of these components. provide 4 g of taurine (i.e. half the dose that caused excessive Patients with end-stage renal disease are reported to be accumulation of taurine and neurological symptoms in our taurine depleted with low plasma and muscle intracellular patients). Although the symptoms were relatively mild and concentrations of taurinew4x. Since taurine depletion is rapidly disappeared after stopping the taurine intake, long- potentially harmful for these patients, who frequently have term risks of excessive taurine accumulation cannot be ruled heart failure, muscular fatigue and neurological symptoms, out. We strongly suggest that cans or bottles of energy drinks we decided to make an open, non-randomized trial in ten containing taurine should have a label, which warns against chronic haemodialysis patients on the effect of daily oral their use by patients with kidney failure. taurine substitution for 10 weeks on various neurophysio- logical parameters, and plasma and muscle levels of taurine. Divisions of Baxter NovumMohamed E. Suliman The dose of taurine, 100 mgukguday, was similar to that pre- and Renal MedicinePeter Ba´ra´ ny viously used in human clinical trialsw2x. The protocol was DepartmentofClinicalScience Jos´eC.DivinoFilho approved by the Ethics Committee of Karolinska Institutet Karolinska InstitutetBengt Lindholm at Huddinge University Hospital. HuddingeUniversityHospital JonasBergstr¨om One patient completed the study with no symptoms or side Stockholm, Sweden effects. The second patient underwent kidney transplantation Email: [e-mail] after 7 weeks of taurine, which was withdrawn immediately 1. HuxtableRJ. Physiological actions of taurine.Physiol Rev1992; before transplantation. No symptoms that could be related 72: 101–163 to the intake of taurine were reported. The third patient 2. Azuma J, Hasegawa H, Sawamura A. Taurine for treatment of completed the study but complained of dizziness at the end of congestive heart failure.Int J Cardiol1982; 2: 303–309 it, which disappeared within 24 h after stopping the taurine 3. GeissK-R, Jester I, Falke W, Hamm M, Waag K-L. The effect intake. The fourth patient reported increasing dizziness and of a taurine-containing drink on performance in 10 endurance non-rotatory vertigo and withdrew from the study after 2.5 athletes.Amino Acids1994; 7: 45–56 weeks. The symptoms resolved within 24h after discon- ,AuFsrPtL,nihdlomB.SulphuraminotsgreB.4AlJ,¨mrondrastve tinuing taurine. This patient was rechallenged after 3 days acids in plasma and muscle in patients with chronic renal failure: with half the dose of taurine (50 mgukguday) and the same evidence for taurine depletion.J Intern Med1989; 226: 189–194