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  Česky / Czech version Centr. eur. J. publ. Hlth, 9, 2001, No. 2, p. 56-62
 
Long-term Effects of Low-protein Diet Supple- mented with Ketoacids and Erythropoietin on Lipid Metabolism and Progression of Renal Failure: Czech Multicentre Study 
Teplan V., Schück O., Knotek A., Hajný J., Horáèková M., Poledne R., 

Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Department of Internal Medicine, Liberec, Czech Republic, Department of Internal Medicine, Chrudim, Czech Republic, Department of Internal Medicine, Medical Faculty III, Charles University, Prague, Czech Republic, Atherosclerosis Research Laboratory, Institute for Clinical and Experimental Medicine, Prague, Statistics Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
 


Summary:

       Ketoacids (KA) and recombinant human erythropoietin (rHuEPO) may influence the metabolic status of patients with chronic renal failure (CRF). A long-term prospective randomized study was designed to monitor the metabolic and nutritional status and progression of CRF using three therapeutic protocols: (A) low-protein diet (LPD) with 0.6 g protein and 35 kcal/kg/day, with recombinant human erythropoietin (rHuEPO), 40 U kg/week and ketoacids (KA) 100 mg/kg/day, (Group I), (B) LPD and rHuEPO (Group II), and (C) LPD only (G roup III). A total of 105 patients (50M/55F), aged 26–78 years, C Cr 22–36 ml/min, were monitored at the beginning, and every 6 months for 3 years in the above three study groups. Group I comprised 35 patients, Group II 38 patients and Group III 32 patients. During the follow-up, a significantly smaller decrease in GFR (CCr, Cin) and in 1/SCr, and an increase in serum albumin, transferrin, leucine, body mass index and HDL-cholesterol were found in Group I (all p < 0.01). In addition, significant decreases were also seen in proteinuria, renal fractional leucine excretion and serum triglyceride levels (p < 0.01). Co-administration of LPD, rHuEPO and KA thus constitutes an effective alternative to conservative manage- ment of CRF, delaying in the follow-up period progression of renal failure and correction of metabolic parame- ters.

        Key words: ketoacids, erythropoietin, low protein diet, lipids, renal failure.
       

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