title: [The effect of low-protein diet supplemented with ketoacids in patients with chronic renal failure].
abstract: It is known that dietary protein restriction slows the progression of chronic renal disease. If daily protein intake is less than 0.5-0.6 g/kgbw, the diet has to be supplemented with essential aminoacids/ketoacids. In this study the authors evaluate the long-term effect of low-protein diet supplemented with ketoacids on the progression of chronic renal failure, calcium and phosphorus metabolism, nutritional status, the compliance of patients and the permanent dietary education for the compliance. 51 predialysis patients have been treated with ketoacids supplemented low-protein diet during 12-57 months (mean treatment period: 26 months). Serum creatinine raised from 349.72+/-78.04 micromol/l to 460.66+/-206.66 micromol/l (27 micromol/l/year or 2.3 micromol/l/month), glomerular filtration rate (GFR) decreased from 21.52+/-7.84 ml/min to 18.22+/-7.76 ml/min (0.83 ml/min/year or 0.07 ml/min/month). The slope of 1/serum creatinine versus time was 0.0018 by linear regression analysis. Serum parathormon decreased significantly, but serum calcium and phosphorus did not change. Nutritional status of patients did not change significantly during the follow-up period. Protein intake decreased significantly and remained at this lower level during the treatment period. According to results: low-protein diet supplemented with ketoacids was effective in slowing progression of chronic renal failure, decreased PTH, did not change nutritional status. With permanently and good education it was possible to keep patients on low-protein diet for a long period.
authors.affiliation: Fresenius Medical Care Dialízis Centrum Szigetvár Szt. István ltp. 7. 7900. marta.molnar@fmc-ag.com
authors.forename: Márta
authors.initials: M
authors.lastname: Molnár
authors.forename: Margit
authors.initials: M
authors.lastname: Szekeresné Izsák
authors.forename: Judit
authors.initials: J
authors.lastname: Nagy
authors.forename: Mária
authors.initials: M
authors.lastname: Figler
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D018753:Diet, Protein-Restricted / Q000379:methods; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007651:Keto Acids / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood; D010349:Patient Compliance; D010353:Patient Education as Topic; D010758:Phosphorus / Q000097:blood / Q000378:metabolism; D013997:Time Factors
chemical_list: D007651:Keto Acids; D010281:Parathyroid Hormone; D010758:Phosphorus; D003404:Creatinine; D002118:Calcium