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Arginine + glutamate is an experimental amino acid combination therapy developed by Erasmus University Medical Center (Erasmus MC) to address muscle protein turnover abnormalities in patients with end-stage kidney disease (ESKD) undergoing hemodialysis. Hemodialysis is a catabolic process that leads to significant amino acid loss and muscle wasting. Arginine serves as a precursor for nitric oxide and a potent stimulator of growth hormone and insulin, which promote protein synthesis. Glutamate plays a central role in nitrogen metabolism and serves as a precursor for glutamine, which is essential for muscle cell volume and protein balance. By supplementing these specific amino acids during dialysis, the therapy aims to shift the muscle protein balance from a net catabolic state to a neutral or anabolic state, potentially improving physical function and outcomes in this patient population.
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