The effect of the diet of nitrogen‐free analogs of essential amino acids on chronic kidney disease deterioration: A meta‐analysis

2022 ◽  
Author(s):  
Wenjuan Yang
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Essential Amino Acids

scholarly journals The value of a low-protein diet and ketoanalogues of essential amino acids in the сontrol of protein carbamylation and toxic effects of urea in chronic kidney disease

2021 ◽  
Vol 93 (6) ◽  
pp. 729-735
Author(s):  
Nataliia A. Mikhailova
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Kidney Disease ◽  
Essential Amino Acids ◽  
Cardiovascular Complications ◽  
Uremic Toxins ◽  
Protein Diet ◽  
Toxic Effects ◽  
Low Protein Diet ◽  
Low Protein

Chronic kidney disease (CKD) is characterized by high mortality from cardiovascular diseases, the development of which is facilitated by traditional risk factors (typical for the general population) and by nontraditional ones (specific to patients with CKD) as well. These factors include also uremic toxins, for which a causal relationship has been established with specific pathological processes in patients with CKD, comprising the development of vascular dysfunction and accelerated progression of atherosclerosis. Urea has long been considered not as a uremic toxin, but as a marker of metabolic imbalance or dialysis efficiency (Kt/V) in CKD patients. In recent years, more and more publications have appeared on the study of the toxic effects of urea with the development of toxic-uremic complications and the phenotype of premature aging, common in CKD. It was found that an increase in urea levels in uremic syndrome causes damage to the intestinal epithelial barrier with translocation of bacterial toxins into the bloodstream and the development of systemic inflammation, provokes apoptosis of vascular smooth muscle cells, as well as endothelial dysfunction, which directly contributes to the development of cardiovascular complications. The indirect effects of increased urea levels are associated with carbamylation reactions, when isocyanic acid (a product of urea catabolism) changes the structure and function of proteins in the body. Carbamylation of proteins in CKD patients is associated with the development of renal fibrosis, atherosclerosis and anemia. Thus, urea is now regarded as an important negative agent in the pathogenesis of complications in CKD. Studies on a low-protein diet with using ketoanalogues of essential amino acids to minimize the accumulation of urea and other uremic toxins demonstrate the clinical benefit of such an intervention in slowing the progression of CKD and the development of cardiovascular complications.

scholarly journals Nutritional support for patients with chronic kidney disease at pre-dialysis stages

2020 ◽  
Vol 92 (6) ◽  
pp. 117-123
Author(s):  
Alexandra V. Kuzmina
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Body Weight ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Essential Amino Acids ◽  
Diet Therapy ◽  
Main Task ◽  
Protein Energy ◽  
Poor Outcomes

Chronic kidney disease (CKD) is characterized by poor outcomes, an increasing frequency of new cases, the need for expensive method of renal replacement therapy at the terminal stage. The main task facing the doctor is slowing the progression of CKD and delay the start of dialysis by applying the nephroprotective strategy, of which diet therapy is an essential part. The key components of the diet for CKD patients are reducing sodium intake to 2.3 g per day in order to improve control of blood pressure (BP), dietary protein restriction adequate to renal function from 0.8 to 0.3 g/kg of body weight per day combined with the prescribing of ketoanalogues of essential amino acids, hyperglycemia control. With the progression of CKD, the main objectives of the diet therapy are the prevention/correction of complications: protein-energy waisting, metabolic acidosis, ensuring sufficient calories, corresponding to the bodys energy expenditures (3035 kcal/kg of body weight per day), limiting phosphate intake to 0.81 g a day, restriction of food potassium. Low-protein diet in combination with ketoanalogues of amino acids, regular monitoring and correction of the nutritional status of patients at the pre-dialysis stages of CKD is an effective and safe method of nephroprotection, which allows delaying the start of dialysis.

scholarly journals Role of rhubarb and α-keto analogues of essential amino acids supplementation in halting progression of chronic kidney disease

2017 ◽  
Vol 5 (6) ◽  
pp. 2581
Author(s):  
Irfan Ahmad Khan ◽  
Mohammad Nasiruddin ◽  
Shahzad F. Haque ◽  
Rahat A. Khan
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Kidney Disease ◽  
Conservative Management ◽  
Biochemical Parameters ◽  
Essential Amino Acids ◽  
Gradual Improvement ◽  
Group I ◽  
Total Urine ◽  
Keto Analogues

Background: Chronic kidney disease (CKD) is an emerging chronic disease due to rapidly increasing incidence of diabetes and hypertension worldwide. Newer drugs are being searched which can stop nephron damage and are cost effective. This study was undertaken to compare the efficacy and safety profile of rhubarb and α-keto analogues of essential amino acids supplementation in patients of chronic kidney disease.Methods: A prospective comparative study was conducted in patients of chronic kidney disease attending Renal Clinic of a tertiary care centre. Randomization of patients was done into three interventional groups: conservative management along with placebo was given in first group (Control); conservative management along with Rhubarb capsule (350 mg, thrice daily) was given in second group (Rhubarb) and conservative management along with α-keto analogues of essential amino acids (600 mg, thrice daily) was given in third group (KAA). The treatment was given for 12 weeks. Clinical and biochemical parameters were assessed at 0, 4, 8 and 12 weeks of treatment.Results: Patients of all three groups showed gradual improvement in clinical features and biochemical parameters as compared to their pre-treated values which was more marked in KAA supplemented group. There was reduction in: fasting blood glucose (12.51%, 19.15% and 20.78%), PPBG (14.80%, 19.00% and 20.89%), serum creatinine (25.00%, 30.54% and 39.52%), blood urea (25.55%, 33.64% and 38.09%), and 24-hour total urine protein (TUP) (19.80%, 30.18% and 38.34%) in Group I, II and III respectively. There was increase in: haemoglobin level (12.64%, 14.99% and 19.77%), 24-hour total urine volume (TUV) (19.41%, 28.82% and 33.32%) and GFR (22.6%, 46.5% and 49.2%) in Group I, II and III respectively. Rhubarb and KAA supplementations were safe and well-tolerated.Conclusions: KAA is more effective than Rhubarb as add on therapy with conservative management in patients of chronic kidney disease.

scholarly journals Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet

Metabolites ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 844
Author(s):  
Marcio Antonio Brunetto ◽  
Doris Pereira Halfen ◽  
Larissa Wunsche Risolia ◽  
Vivian Pedrinelli ◽  
Douglas Segalla Caragelasco ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Kidney Disease ◽  
Essential Amino Acids ◽  
Control Group ◽  
Isoleucine Leucine ◽  
Renal Diet ◽  
Healthy Dogs ◽  
Branched Chain ◽  
Urinary Amino

This observational study aimed to evaluate serum and urinary amino acid (AA) concentrations in healthy dogs and dogs with chronic kidney disease (CKD) fed a commercial therapeutic renal diet with reduced protein and phosphorus levels. Ten dogs with CKD stages 3 or 4 composed the study group and received the renal diet for 180 days (RG T180). A control group (CG T30) composed of seven healthy dogs was fed a renal diet for 30 days. When comparing serum AA between RG T180 and CG T30, histidine, isoleucine, leucine, lysine, phenylalanine, tryptophan, cysteine, citrulline, ornithine, taurine, branched-chain amino acids (BCAA), and total essential amino acids (EAA) were higher in RG T180. Meanwhile, arginine, asparagine, aspartate, glutamine, serine, and tyrosine were higher in CG T30. Serum phenylalanine, tryptophan, and hydroxyproline were higher in RG T0 (dogs with CKD before consuming a renal diet) when compared to RG T180. In addition, the serum ratios of arginine/citrulline, tyrosine/phenylalanine, and serine/glycine were higher in CG T30 than in RG T180. Concerning urinary AA concentrations in CKD dogs, isoleucine, phenylalanine, tryptophan, aspartate, cysteine, and BCAA were higher in RG T180. In urine, the total EAA/total non-essential AA ratio in RG T180 was higher than in CG T30 as well as tyrosine/phenylalanine ratio higher in CG T30. In conclusion, the combination of renal diet and conservative treatment over 6 months in dogs with CKD stages 3 or 4 affected the AAs metabolism when compared to healthy adult dogs.

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