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 |
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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 2678 years, C Cr 2236 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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