• Corpus ID: 20259081

Progression of chronic renal failure on substituting a ketoacid supplement for an amino acid supplement.

@article{Walser1992ProgressionOC,
  title={Progression of chronic renal failure on substituting a ketoacid supplement for an amino acid supplement.},
  author={Mackenzie Walser and S B Hill and L Ward},
  journal={Journal of the American Society of Nephrology : JASN},
  year={1992},
  volume={2 7},
  pages={
          1178-85
        }
}
Twelve patients with severe chronic renal failure (average initial GFR, 13 mL/min) were monitored for 4 to 23 months while receiving an essential amino acid supplement and were then switched to a ketoacid supplement for 6 to 40 months, while continuously receiving a very low-protein (0.3 g/kg), low-phosphorus (7 to 9 mg/kg) diet. Urinary urea N excretion indicated that actual dietary protein intake averaged 0.46 g/kg. Progression, estimated as the linear regression slope of radioisotopically… 
Very low protein diet plus ketoacid analogs of essential amino acids supplement to retard chronic kidney disease progression
TLDR
VLPD supplementation with KA/EAA is associated with delayed renal progression while preserving the nutritional status in the patients with CKD and may prove an effective alternative to conservative management of CKD.
A crossover comparison of progression of chronic renal failure: ketoacids versus amino acids.
TLDR
It is concluded that KA slow progression, relative to AA, independently of protein or phosphorus intake, in patients on this regimen is concluded.
Adaptive responses to very low protein diets: the first comparison of ketoacids to essential amino acids.
Eight patients with chronic renal failure (GFR 18.8 +/- 2.7 ml/min) were randomized to a crossover comparison of a very low protein diet (VLPD) containing 0.28 g protein and 35 kcal per kg per day,
Can renal replacement be deferred by a supplemented very low protein diet?
  • M. Walser, S. Hill
  • Medicine
    Journal of the American Society of Nephrology : JASN
  • 1999
TLDR
Patients with chronic renal failure who met these criteria on presentation or who reached these levels of severity during treatment were managed conservatively until RRT was judged necessary by their chosen dialysis or transplantation team, and it was concluded that further study of this approach is indicated.
Effects of a Supplemented Very Low Protein Diet in Predialysis Patients on the Serum Albumin Level, Proteinuria, and Subsequent Survival on Dialysis
  • M. Walser
  • Medicine, Biology
    Mineral and Electrolyte Metabolism
  • 1997
TLDR
It is shown that when nephrotic patients are given this regimen, they rarely exhibit hypoalbuminemia, in contrast to the reported 25–50% hypo Albuminemia at the onset of dialysis nationwide, and their survival for the first 2 years on dialysis is much improved, in comparison with the national experience, adjusted for age, sex, and cause of renal disease.
Effect of dietary protein restriction on nutritional status in the Modification of Diet in Renal Disease Study.
TLDR
The analyses suggest that the low-protein and very-low-protein diets used in the MDRD Study are safe for periods of two to three years, but both protein and energy intake declined and there were small but significant declines in various indices of nutritional status.
Does prolonged protein restriction preceding dialysis lead to protein malnutrition at the onset of dialysis?
  • M. Walser
  • Medicine, Biology
    Kidney international
  • 1993
TLDR
In five patients who exhibited subnormal albumin and transferrin and high cholesterol concentrations at the beginning of dietary therapy, albuminand transferrin levels rose to normal or nearly normal, and hypercholesterolemia receded during the ensuing four months; this predialysis dietary regimen prevents protein malnutrition; when protein malnutrition is present, this regimen corrects it.
Low protein diets are mainstay for management of chronic kidney disease.
Low protein diets, made either of natural foods or of L-essential amino acids and/or their nitrogen-free ketoanalogues, are feasible, safe, and efficient means to reduce disease progression in
Effects of dietary protein restriction on the progression of advanced renal disease in the Modification of Diet in Renal Disease Study.
  • A. Levey, S. Adler, P. Teschan
  • Medicine
    American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 1996
Better preservation of residual renal function in peritoneal dialysis patients treated with a low-protein diet supplemented with keto acids: a prospective, randomized trial.
  • N. Jiang, J. Qian, Q. Yao
  • Medicine, Biology
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2009
TLDR
A diet containing 0.6-0.8 g of protein/kg IBW/day is safe and, when combined with keto acids, is associated with an improved preservation of RRF in relatively new PD patients without significant malnutrition or inflammation.
...
...

References

SHOWING 1-10 OF 24 REFERENCES
Progression of chronic renal failure in patients given ketoacids following amino acids.
TLDR
This ketoacid supplemented regimen apparently halted the progression of moderately-severe chronic renal failure for at least a year in a small group of patients in whom restriction of protein and phosphate intake without ketoacids failed to halt progression.
The effect of a keto acid-amino acid supplement to a restricted diet on the progression of chronic renal failure.
TLDR
This regimen with a low-phosphorus diet containing 20 to 30 g of mixed-quality protein, supplemented by amino acids and their keto analogues must have slowed or halted the progression of renal insufficiency in a majority of cases, especially when treatment was initiated before creatinine had reached the level of 8 mg per deciliter.
Progression of chronic renal failure is related to glucocorticoid production.
TLDR
Progression of chronic renal failure during 35 treatment periods in 27 patients was measured as the rate of change of bimonthly radioisotope GFR for an average of 15 months, and additional significant regressors appeared: serum triglycerides and polycystic kidney disease and ketoacid treatment, which tended to be associated with more rapid progression.
Effects on renal function of a low-nitrogen diet supplemented with essential amino acids and ketoanalogues and of hemodialysis and free protein supply in patients with chronic renal failure.
TLDR
In the third group of uremics on repeated dialysis therapy, the deterioration of creatinine clearance was markedly accelerated and the possible explanations and the practical implications of these findings are discussed.
A method for estimating nitrogen intake of patients with chronic renal failure.
TLDR
From the estimated total nitrogen excretion, dietary compliance of CRF patients in approximately neutral nitrogen balance could be assessed and nitrogen balance calculated using estimated U and 31 mg N/kg/day was indistinguishable statistically from measured nitrogen balance.
Effects of a low-phosphorus, low-protein diet supplemented with essential amino acids and keto analogues on 'overt' diabetic nephropathy.
TLDR
In conclusion, on the basis of these preliminary observations, the SD seems to exert several beneficial and no unwanted side-effects in renal failure of type I diabetics.
Stockholm clinical study on progression of chronic renal failure--an interim report.
TLDR
There was a significant correlation between the change in progression rate and thechange in mean arterial pressure, a relationship which was also present in patients with mild hypertension or those with blood pressure within the "normal" range.
Ketoacids in the treatment of uremia.
TLDR
When KA were given after EAA, urea appearance fell and N balance improved, and when EAA were give after KA (5 studies), Urea appearance and N Balance did not worsen significantly during the 4-9 days of observation.
Role of branched-chain ketoacids in protein metabolism.
TLDR
The purpose of this review is to summarize the current knowledge concerning the role of endogenous BCKA in protein metabolism and the effect of exogenous BCKA on N balance, with particular reference to renal failure.
...
...