Conservative treatment with ketoacid and amino acid supplemented low-protein diets in chronic renal failure.

Twenty-six patients with advanced renal failure (glomerular filtration rate less than 6 ml/min) were treated with a mixed quality low protein diet and ketoacid analogues. An improvement in nitrogen balance, serum transferrin and phosphate, and base excess was observed after 2 weeks of treatment. In a longer term study, the result of 20 patients treated with ketoacids for up to 14 months were compared to a group 40 patients who received a low-protein diet with essential amino acids. Patients responded similarly to the two diets; however, the group receiving ketoacids had a significantly lower glomerular filtration rate. There was improvement in calcium and phosphate metabolism with ketoacid treatment. The patients were able to tolerate treatment with both the ketoacids and vitamin D.