TY - JOUR T1 - 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. AU - Zakar,G, AU - ,, PY - 2001/10/18/pubmed PY - 2002/1/5/medline PY - 2001/10/18/entrez SP - 688 EP - 94 JF - Wiener klinische Wochenschrift JO - Wien Klin Wochenschr VL - 113 IS - 17-18 N2 - 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. SN - 0043-5325 UR - https://www.unboundmedicine.com/medline/citation/11603104/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_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -