A controlled study of supplementation with essential amino acids and alpha-keto acids in the conservative management of patients with chronic renal failure.

Oral therapy with essential amino acids (EAA) or alpha-keto acids (alpha-KA) has been recommended in patients with renal failure, but quality and quantity of optimal protein intake are still controversial. This study compares sequentially the effect of supplementation with EAA, and with alpha-KA versus placebo in 15 ambulatory patients with chronic renal failure (average creatinine clearance 10.8 ml/min), maintained on a protein diet of 0.57 g/kg body weight (40 g for a 70-kg patient). The actual dietary intake averaged 0.55 g protein/kg and 27 kcal/kg according to repeated 7-day dietary recordings. After a 6-week baseline period on this diet, all patients received additionally 0.112 g EAA/kg for 6 weeks followed by a double-blind crossover study of 0.105 g alpha-KA/kg versus placebo supplementation for 6 weeks each. Fasting blood samples for multiple parameters, including 15 indicators for protein deficiency, as well as anthropometric and clinical data were evaluated every 3 weeks. Laboratory data revealed no indications of protein deficiency. Therapy with alpha-KA diminished serum phosphate concentration (p less than 0.05), however no other significant beneficial effects could be demonstrated during supplementation with either EAA or alpha-KA. Therefore, such supplementation to a 0.55-g/kg-protein diet appears superfluous in stable ambulatory patients with renal insufficiency.

RCT Entities:   Population Interventions Outcomes