Dietary Protein Requirements in Hemodialysis Patients

Inclusion Criteria: * Ages from 30 years through 65 years * Both men and women and all ethnic and racial groups * Treatment with MHD for 6 months or greater * Hemoglobin of at least 11 g/dL * Neurological examination indicating no severe neuropathy * A negative test for peripheral arterial occlusive disease Exclusion Criteria: * Obesity: body weight greater than \>115% of standard * History of active cancer other than basal cell carcinoma * Symptomatic severe ischemic heart disease, uncontrolled serious dysrhythmias, uncontrolled congestive heart failure, poorly controlled hypertension, severe musculoskeletal disease, arthritis or amputations of the lower extremities * Insulin dependent or insulin independent diabetes mellitus * Severe lung or liver disease, uncontrolled asthma, active vasculitis. Severe chronic infection or any other acute or chronic inflammatory or catabolic illnesses * Psychosis, inability to give informed consent, evidence that patient will not comply with study protocol * Alcohol or other recreational drug abuse * Patients who received L-carnitine or anabolic hormones within the previous 6 months * Pregnancy * Patients who are physically and/or psychologically incapable of undergoing the protocol