The plasma aminogram in uremic children receiving conservative treatment or undergoing hemodialysis demonstrated a similar profile to that first described in adults and children. We were able to demonstrate that dialysis did not correct the abnormal plasma amino acid pattern and that free amino acid losses in the dialysate during hemodialysis could not be compensated for by children receiving an adequate protein intake. Oral supplementation with essential amino acids (EAA) or ketoanalogues (KAA) only partially corrected the amino acid abnormalities and biochemical improvement in protein metabolism was not observed, however, increasing the relative proportions of branch chain amino acids in the supplement might be associated with improvement in metabolism. These data are in contrast to previous studies on the use of EAA or KAA in adults and children in which patients received a reduced protein intake, whereas in the present study protein intake was not restricted. The raised plasma levels of methionine and 3-methyl-histidine were not associated with side effects.