Supplementary Material for: L-Glutamine induced acute kidney injury; a clinical observation.

Introduction: L-Glutamine is increasingly used as a dietary supplement and its use is, as is the case with other amino acids, considered safe. L-Glutamine is the most abundant amino acid in the human body and is involved in many metabolic reactions. Within the kidney L-Glutamine has an important role in the generation of ammonia and bicarbonate. Case presentation: We report a case of acute kidney injury (AKI) as a result of tubular damage in a patient who used 18 grams of L-glutamine on a daily basis. Possible mechanisms are proposed of which increased single nephron ammonia production and toxicity seems most likely cause of AKI. Conclusion: We advise cautious use of L-Glutamine supplements in elderly patient with an already compromised kidney function.

引言：L-谷氨酰胺（L-Glutamine）作为膳食补充剂的应用日益广泛，与其他氨基酸类补充剂一样，其应用安全性已获广泛认可。L-谷氨酰胺是人体内含量最为丰富的氨基酸，参与众多代谢反应。在肾脏内，L-谷氨酰胺在氨与碳酸氢盐的生成过程中发挥重要作用。

病例报告：本文报道1例患者每日服用18克L-谷氨酰胺后，因肾小管损伤引发急性肾损伤（acute kidney injury, AKI）的病例。本文提出了数种可能的致病机制，其中单肾单位氨生成增加及其毒性作用被认为是引发该急性肾损伤的最可能原因。

结论：我们建议对于肾功能已受损的老年患者，应谨慎使用L-谷氨酰胺补充剂。