The effect of a keto acid supplement on the course of chronic renal failure and nutritional parameters in predialysis patients and patients on regular hemodialysis therapy: the Hungarian Ketosteril Cohort Study.

Abstract

UNLABELLED:

The results of the Hungarian Ketosteril follow up cohort study are reported. Aim of the study was to evaluate the feasiblity and effects of a low protein diet supplemented with keto acids/amino acids (KA) on the progression of chronic renal failure (CRF) in a large group of predialysis patients (PRE) and on nutritional parameters in both PRE and dialysis patients (DIA).

PATIENTS AND METHODS:

PRE (N = 181) and DIA (N = 42) patients treated in 47 hungarian nephrology and dialysis centres were followed through 18 months. A standardized dietary and KA supplementation protocol was prescribed (PRE group: KA 0.1 g/kgBW/day; dietary protein 0.5-0.6 g/kgBW/day; energy 30 kcal/kgBW/day; DIA group: dietary protein 1.2 g/kgBW/day, KA and energy prescription similar to the PRE group). Progression of CRF was evaluated by linear regression analysis of 1/serum Creatinine (sCr) values versus time, subjective global assessment (SGA) scores were analyzed by Chi-square test, other metabolic parameters (serum albumin, parathormone [iPTH], Ca/P product) were analyzed by descriptive statistics.

RESULTS:

In PRE patients slopes of 1/sCr were in the range of 0.0022-0.0015 [100 ml/mg x month], showing no significant difference in the three subgroups of PRE patients (Group A: initial serum creatinine (sCr) 201-400, Group B: sCr 401-600, Group C: sCr > 600 mmol/L). Serum albumin levels below 35 g/L improved significantly, iPTH levels showed a tendency to improve during KA supplementation. In dialysis patients there was an improvement in SGA scores. Midweek predialysis blood urea and sCr levels did not change significantly.

CONCLUSIONS:

In a large group of PRE patients prescription of a low protein diet supplemented with KA is feasible and leads to a diminution of 1/sCr equation slopes independent from the degree of renal dysfunction, suggesting a retardation in the rate of CRF progression. There was an improvement in nutritional parameters both in PRE and DIA patients, the latter being characterized by improved SGA scores.

• Authors: G Zakar, Hungarian Ketosteril Cohort Study
• Journal: Wiener klinische Wochenschrift (Wien Klin Wochenschr) Vol. 113 Issue 17-18 Pg. 688-94 (Sep 17 2001) ISSN: 0043-5325 [Print] Austria
• PMID: 11603104 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Chemical References

• Amino Acids
• Amino Acids, Essential
• Keto Acids
• ketosteril
• Creatinine

Topics

• Adult
• Aged
• Aged, 80 and over
• Amino Acids (therapeutic use)
• Amino Acids, Essential (therapeutic use)
• Cohort Studies
• Creatinine (blood)
• Diet, Protein-Restricted (methods)
• Dietary Supplements
• Female
• Food, Formulated
• Humans
• Hungary
• Keto Acids (therapeutic use)
• Kidney Failure, Chronic (blood, diet therapy)
• Male
• Middle Aged
• Nutritional Status
• Renal Dialysis
• Severity of Illness Index
• Treatment Outcome