A COMPARISON OF PROGRESSION OF CHRONIC RENAL FAILURE: LOW DOSE VS STANDARD DOSE KETOACIDS

Abstract

Purpose: It has been documented that a low protein diet (LPD) with ketoacid analogues (one ketosteril® /5 kg) can postpone dialysis therapy in chronic kidney disease. The purpose of the study was to compare the effects of residual renal function preservation between low dose (one ketosteril® /10 kg) and standard dose (one ketosteril® /5 kg) ketoacid analogues. Methods: The study was a prospective, open-label, group-comparison design. The duration was 6 months. Patients were enrolled in two hospitals when the serum Cr more than 6 mg/dL (CKD stage 4,5). Then the enrolled patients were randomized to three groups, LPD, LPDK1 (LPD + standard dose ketosteril®), LPDK2 (LPD + low dose ketosteril®). The definition of LPD was 0.6-0.8 gm of protein/kg body weight/day. The comparable variables were routine hemogram, bio-chemistry data, iPTH, reciprocal Cr (1/Cr), (eGFR), UN/Cr levels in 24-hr urine (UUN/UCr). The measurements were performed in baseline and 6th month. Results: Demographics of patients were LPD: 22 (M/F:10/12), 49.5 y/o, BMI 21.5±3.3; LPDK1:21 (8/13), 53.6 y/o, BMI 22.7±3.5; LPDK2:37 (15/22), 62 y/o (p: Conclusions: The 6-month observation study showed low dose ketoacid analogues combined with LPD had a beneficial effect to slow down renal function deterioration in CKD stage 4,5. However, the slope of 1/Cr levels in low dose ketoacid analogues was less than that in standard dose ketoacid analogues.