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Keto-analogues and essential aminoacids and other supplements in the conservative management of chronic kidney disease.
Panminerva Med. 2017 Jun; 59(2):149-156.PM

Abstract

The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with the aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of chronic kidney disease (CKD) patients. Additional features, though strictly related to proteins, include modifications in sodium, phosphorus and energy intake, as well as in the source (animal or plant derived) of protein and lipids. In addition, supplements play an important role as a means to obtain both beneficial effects and nutritional safety in the renal patient. Essential amino acid and ketoacid mixtures are the most utilized types of supplementation in CKD patients on restricted protein regimens. The essential amino acids plus ketoacid supplementation is mandatory in conjunction with a very low-protein diet in order to assure an adequate essential amino acid supply. It is needed to safely implement a very low protein (and phosphorus) intake, so as to obtain the beneficial effect of a severe protein restriction while preventing malnutrition. Protein-free products and energy supplements are also crucial for the prevention of protein-energy wasting in CKD patients. Calcium, iron, native vitamin D and omega-3 PUFAs are other types of supplementation of potential benefits in the CKD patients on conservative management.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy - adamasco.cupisti@med.unipi.it.Territorial Department of Nephrology and Dialysis, ASL 8, Cagliari, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28001026

Citation

Cupisti, Adamasco, and Piergiorgio Bolasco. "Keto-analogues and Essential Aminoacids and Other Supplements in the Conservative Management of Chronic Kidney Disease." Panminerva Medica, vol. 59, no. 2, 2017, pp. 149-156.
Cupisti A, Bolasco P. Keto-analogues and essential aminoacids and other supplements in the conservative management of chronic kidney disease. Panminerva Med. 2017;59(2):149-156.
Cupisti, A., & Bolasco, P. (2017). Keto-analogues and essential aminoacids and other supplements in the conservative management of chronic kidney disease. Panminerva Medica, 59(2), 149-156. https://doi.org/10.23736/S0031-0808.16.03288-2
Cupisti A, Bolasco P. Keto-analogues and Essential Aminoacids and Other Supplements in the Conservative Management of Chronic Kidney Disease. Panminerva Med. 2017;59(2):149-156. PubMed PMID: 28001026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Keto-analogues and essential aminoacids and other supplements in the conservative management of chronic kidney disease. AU - Cupisti,Adamasco, AU - Bolasco,Piergiorgio, Y1 - 2016/12/21/ PY - 2016/12/22/pubmed PY - 2017/8/11/medline PY - 2016/12/22/entrez SP - 149 EP - 156 JF - Panminerva medica JO - Panminerva Med VL - 59 IS - 2 N2 - The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with the aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of chronic kidney disease (CKD) patients. Additional features, though strictly related to proteins, include modifications in sodium, phosphorus and energy intake, as well as in the source (animal or plant derived) of protein and lipids. In addition, supplements play an important role as a means to obtain both beneficial effects and nutritional safety in the renal patient. Essential amino acid and ketoacid mixtures are the most utilized types of supplementation in CKD patients on restricted protein regimens. The essential amino acids plus ketoacid supplementation is mandatory in conjunction with a very low-protein diet in order to assure an adequate essential amino acid supply. It is needed to safely implement a very low protein (and phosphorus) intake, so as to obtain the beneficial effect of a severe protein restriction while preventing malnutrition. Protein-free products and energy supplements are also crucial for the prevention of protein-energy wasting in CKD patients. Calcium, iron, native vitamin D and omega-3 PUFAs are other types of supplementation of potential benefits in the CKD patients on conservative management. SN - 1827-1898 UR - https://www.unboundmedicine.com/medline/citation/28001026/Keto_analogues_and_essential_aminoacids_and_other_supplements_in_the_conservative_management_of_chronic_kidney_disease_ DB - PRIME DP - Unbound Medicine ER -