Anti-sarcopenic effect of leucine-enriched branched-chain amino acid supplementation among elderly chronic kidney disease patients: a double-blinded randomized controlled trial.

backgroundLeucine, a branched-chain amino acid (BCAA), is an effective nutritional strategy to enhance skeletal muscle mass in aging populations. This study aimed to evaluate the effects of oral leucine-enriched BCAA supplementation on muscle mass, muscle synthesis biomarkers, and physical performance in elderly patients with chronic kidney disease (CKD).

methodsA randomized controlled trial was conducted among CKD patients aged over 65 years. The participants were randomly assigned to receive either oral mixed BCAA supplementation (60% leucine, 4.5 g/day; 20% valine, 1.5 g/day; 20% isoleucine, 1.5 g/day) (N = 29) or a placebo (N = 26) for 12 weeks. Muscle mass, serum insulin-like growth factor 1 (IGF-1), and myostatin levels were measured at baseline and after 12 weeks. A 3-day food record was reviewed by a dietitian, and functional capacity was assessed using handgrip and 6-min walk tests.

resultsFifty-five patients (mean age 75.4 ± 5.2 years) were enrolled. Daily protein and calorie intake were comparable between groups. At study conclusion, lean muscle mass significantly increased in the leucine group compared to placebo (0.4 kg [95% CI 0.1-0.7] vs. - 0.2 kg [95% CI - 0.6-0.2], P = 0.010). A significant difference in the percentage change in muscle mass was also observed (1.0 ± 1.8% vs. - 0.5 ± 2.6%, P = 0.014). No significant differences were found in muscle strength, serum myostatin, IGF-1, or adverse events.

conclusionsLeucine-enriched BCAA supplementation for 12 weeks significantly increased muscle mass but did not impact biomarkers of muscle activity or functional capacity in elderly CKD patients. CLINICAL

trial registrationTCTR20200314003.