Progression of Chronic Renal Failure: A Comparison of Low Dose versus Standard Dose Keto Acid Analogues

BACKGROUND: To evaluate the beneficial effect of a smaller dosage of Ketoanalogs of amino acids (KAs, Ketosteril^®) on the preservation of renal function. METHODS: The study was a prospective, open-label, group-comparison design. The study duration was six months. Patients with chronic kidney disease stage 5, i.e., eGFR ＜ 15 mL/min/1.73 m^2 were enrolled in two hospital-based outpatient clinics and allocated to three groups: low-protein diet (LPD), LPDK1 (LPD + ketosteril^® one tablet/5 kg/day), or LPDK2 (LPD + Ketosteril^® one tablet/10 kg/day). The residual renal function indices (1/Cr, eGFR) and associated biochemical parameters after treatment were analyzed and evaluated. RESULTS: Final numbers of subjects for complete study were LPD: 15, LPDK1: 16, and LPDK2: 14. The mean ages were 51.40 ± 12.55, 55.25 ± 8.68, 62.93 ± 12.03 years in the LPD, LPDK1, and LPDK 2 groups respectively (P = 0.026). By general estimation equation (GEE) model analysis, age (coefficient 4.97E-03, P = 0.038), blood BUN (coefficient -3.43E-03, P ＜ 0.001) and P levels (coefficient -5.57E- 02, P ＜ 0.001) were likely to have revealed significant negative association with 1/Cr levels. The similar negative associations of blood BUN (coefficient -3.61E-03, P ＜ 0.001) and P levels (coefficient -6.75E- 02, P ＜ 0.001) on eGFR levels. Generally, different Ketosteril dose did not show significant association on indices of 1/Cr, eGFR. CONCLUSION: Treatment with a low dose of KAs in CKD patients was not inferior to a standard dose in preventing the progression of renal failure in a short-term observational study.

並列關鍵字

chronic kidney disease ； keto acid analogues ； low-protein diet

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