HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Malvy, D. Articles by Nivet, H. Search for Related Content PubMed PubMed Citation Articles by Malvy, D. Articles by Nivet, H.

Effects of Severe Protein Restriction with Ketoanalogues in Advanced Renal Failure

Centre René Labusquière and INSERM U.330, Université Victor Segalen Bordeaux 2, Bordeaux, (D.M.)
Service de Néphrologie et Immunologie Clinique, CHU Bretonneau, Tours, (C.M., J.P., H.N.) FRANCE

Address reprint requests to: Dr. Denis MALVY, Centre René Labusquière, INSERM U 330, Université Victor Segalen Bordeaux 2, 146, Rue Léo Saignat, F-33 076 Bordeaux Cedex, FRANCE

Objective: To compare a severe protein restriction diet supplemented with ketoanalogues to a moderate protein restriction diet in order to limit glomerular filtration rate (GFR) decrease in an advanced renal insufficiency stage.

Design: Prospective randomised study conducted to compare a severe protein restriction diet (0.30 g/kg/day) supplemented with a preparation of ketoanalogues, hydroxyanalogues of aminoacids and aminoacids (Group A) to a moderate protein restriction diet (0.65 g/kg/day) (Group B).

Patients: 50 uremic patients included (25 in each group) with GFR is <20 mL/min/1.73m².

Results: There were no statistically significant differences between the two dietary regimens for the renal survival. But uremia decreased significantly in Group A (22.7±5.2 to 18.5±6.7 mmol/L) and increased in Group B (26.8±9.0 to 34.9±9.9 mmol/L). Calcemia increased in Group A from 2.28±0.18 to 2.42±0.17 mmol/L, p<0.01 with a stable phosphoremia while calcemia decreased in Group B (2.33±0.18 to 2.25±0.17 mmol/L, p<0.05). At the end of the study, Group A was different from Group B for calcemia (2.42±0.17 vs. 2.25±0.17 mmol/L, p<0.01), phosphoremia (1.39±0.30 vs. 1.80±0.65 mmol/L, p<0.02), alkaline phosphatase (61.42±22.93 vs. 78.8±27.0, p<0.05) and parathormone plasma levels (2.71±1.55 vs. 5.91±1.41 ng/mL, p<0.001).

Comments: Compared to a moderate protein restriction (0.65 g/kg/day), a severe protein restriction (0.3 g/kg/day) supplemented by ketoanologues does not limit GFR decrease when GFR is below 20 mL/min/1.73m², but improves phosphocalcic plasma parameters.

Key words: uremia, protein restriction, renal failure, ketoanalogues

This article has been cited by other articles:

				N. J. M. Cano, D. Fouque, and X. M. Leverve Application of Branched-Chain Amino Acids in Human Pathological States: Renal Failure J. Nutr., January 1, 2006; 136(1): 299S - 307S. [Abstract] [Full Text] [PDF]

				D. Fouque, P. Wang, M. Laville, and J.-P. Boissel Low protein diets delay end-stage renal disease in non-diabetic adults with chronic renal failure Nephrol. Dial. Transplant., December 1, 2000; 15(12): 1986 - 1992. [Abstract] [Full Text] [PDF]