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role of keto acids in chronic kidney disease

Adamasco Cupisti, Piergiorgio Bolasco
The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with the aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of chronic kidney disease (CKD) patients...
June 2017: Panminerva Medica
Min-Tser Liao, Chih-Chien Sung, Kuo-Chin Hung, Chia-Chao Wu, Lan Lo, Kuo-Cheng Lu
Metabolic syndrome and its components are associated with chronic kidney disease (CKD) development. Insulin resistance (IR) plays a central role in the metabolic syndrome and is associated with increased risk for CKD in nondiabetic patients. IR is common in patients with mild-to-moderate stage CKD, even when the glomerular filtration rate is within the normal range. IR, along with oxidative stress and inflammation, also promotes kidney disease. In patients with end stage renal disease, IR is an independent predictor of cardiovascular disease and is linked to protein energy wasting and malnutrition...
2012: Journal of Biomedicine & Biotechnology
Yanlin Wang, William E Mitch
The mechanisms underlying beneficial influences of low-protein diets on the progressive nature of chronic kidney disease are incompletely understood. Gao et al. identify a downregulation of Kruppel-like factor-15 (KLF15) associated with increased renal fibrosis. The KLF15 downregulation and renal fibrosis are reversed with dietary protein restriction, especially when ketoacids are added. The results suggest that KLF15 may play a role in suppressing renal fibrosis and could contribute to the benefits of dietary protein restriction...
May 2011: Kidney International
Xiang Gao, Lianghu Huang, Fabrizio Grosjean, Vittoria Esposito, Jianxiang Wu, Lili Fu, Huimin Hu, Jiangming Tan, Cijian He, Susan Gray, Mukesh K Jain, Feng Zheng, Changlin Mei
Dietary protein restriction is an important treatment for chronic kidney disease. Herein, we tested the effect of low-protein or low-protein plus ketoacids (KA) diet in a remnant kidney model. Rats with a remnant kidney were randomized to receive normal protein diet (22%), low-protein (6%) diet (LPD), or low-protein (5%) plus KA (1%) diet for 6 months. Protein restriction prevented proteinuria, decreased blood urea nitrogen levels, and renal lesions; however, the LPD retarded growth and decreased serum albumin levels...
May 2011: Kidney International
Xiang Gao, Jianxiang Wu, Zheyi Dong, Can Hua, Huimin Hu, Changlin Mei
Dietary protein restriction is one major therapy in chronic kidney disease (CKD), and ketoacids have been evaluated in CKD patients during restricted-protein diets. The objective of the present study was to compare the efficacy of a low-protein diet supplemented with ketoacids (LPD+KA) and a low-protein diet alone (LPD) in halting the development of renal lesions in CKD. 5/6 Nephrectomy Sprague-Dawley rats were randomly divided into three groups, and fed with either 22 % protein (normal-protein diet; NPD), 6 % protein (LPD) or 5 % protein plus 1 % ketoacids (LPD+KA) for 24 weeks...
February 2010: British Journal of Nutrition
Iu S Milovanov, L V Lysenko, L Iu Milovanova, I A Dobrosmyslov
AIM: To evaluate the effects of low-protein diet (LPD) balanced by addition of highly energetic mix and essential keto/amino acids on inhibition of renal failure in patients with systemic diseases with predialysis stages of chronic disease of the kidney (CDK). MATERIAL AND METHODS: Forty six patients with stage III--IV of CDK in systemic diseases (33 SLE patients and 13 with systemic vasculitis) were randomized into three groups. Group 1 consisted of 18 patients with CDK (10 with stage III and 8 with stage IV)...
2009: Terapevticheskiĭ Arkhiv
A Cupisti
Nutritional therapy has a leading role in the conservative treatment of chronic kidney disease (CKD). In the context of CKD, nutritional therapy means designing diets to reduce the patient's intake of proteins, phosphorus and sodium, while preserving adequate energy intake. Nutritional therapy may require also supplementation with calcium carbonate, iron, or essential amino acids and keto acids. Different nutritional strategies can be devised according to the protein needs of CKD patients: diets with controlled protein intake (protein RDA: 0...
September 2008: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Iu S Milovanov, L V Kozlovskaia, L Iu Milovanova
AIM: To assess the rate and clinical significance of impaired nutritional status and impact of low-protein diet on inhibition of renal insufficiency in patients of stage III-IV chronic disease of the kidneys (CDK). MATERIAL AND METHODS: A total of 200 patients with CDK stage III-IV were randomized into three groups: group 1 consisted of 123 patients with chronic glomerulonephritis (73 with stage III and 50 with stage 1V), group 2--45 patients with systemic diseases (30 with stage III and 15 with stage IV), group 3 (a comparison group)--32 patients with CGN (17 with stage 111 and 15 with stage IV)...
2008: Terapevticheskiĭ Arkhiv
Samar Basu
Prostaglandin F2alpha (PGF2alpha), a foremost stable vasoactive cyclooxygenase (COX)-catalyzed prostaglandin, regulates a number of key physiological functions such as luteolysis, ovarian function, luteal maintenance of pregnancy, and parturition as a constitutive part of ongoing reproductive processes of the body. It has recently been implicated in the regulation of intricate pathophysiological processes, such as acute and chronic inflammation, cardiovascular and rheumatic diseases. Since the discovery of a second isoform of COXs, it has been shown that PGF2alpha can be formed in vivo from arachidonic acid through both isoforms of COXs, namely cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2)...
July 2007: Medicinal Research Reviews
Marie-Eve Rodrigue, Sonia Lacasse-M, Richard Larivière, Marcel Lebel
We previously reported that thromboxane (TX)A2 synthesis and receptor blockade prevented recombinant human erythropoietin (rhEPO)-induced hypertension in chronic renal failure rats. The present study was designed to investigate the effect of a cyclooxygenase inhibitor, acetylsalicylic acid (ASA), on blood pressure, renal function, and the concentration of eicosanoïds and endothelin-1 (ET-1) in vascular and renal tissues of rhEPO-treated or rhEPO-untreated uremic rats. Renal failure was induced by a 2-stage 5/6 renal mass ablation...
June 2005: Canadian Journal of Physiology and Pharmacology
Sevgi Mir, Nese Ozkayin, Aysegul Akgun
According to the hyperfiltration theory of renal diseases characterized by a decrease in the number of functional nephrons, increased arterial blood pressure, excessive protein intake in the diet, high levels of calcium (Ca) and phosphorus (P), secondary hyperparathyroidism, hypertriglyceridemia and/or hypercholesterolemia, proteinuria and metabolic acidosis are some factors that impair the prognosis of the disease. The amount of protein in the diet is the most important of these factors. A protein-restricted diet administered to patients with chronic renal failure results in the risk of inadequate amino acid intake...
July 2005: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
S Klahr
The Modification of Diet in Renal Disease (MDRD) Study examined the effect of two interventions, reduction of dietary protein and control of blood pressure below the usual recommended level, on the progression of chronic renal disease. Patients in Study A (N = 585), GFR of 25 to 55 ml/min, were randomized to a group following a usual or low protein diet (1.3 or 0.58 g/kg body wt/day) and maintained at a usual (107 mm Hg) or low (92 mm Hg) mean arterial pressure. Patients in Study B (N = 255), GFR 13 to 24 ml/min, were randomized to a group following a low protein diet or a very low protein diet (0...
June 1996: Kidney International
E M Grieve, G M Hawksworth, J G Simpson, P H Whiting
The ability of thromboxane synthetase inhibition to reverse acute cyclosporin A (CsA)-induced nephrotoxicity in the rat was investigated. CsA administration (50 mg/kg/day p.o. for 14 days) to male Sprague-Dawley rats caused a significant 50% decline in creatinine clearance rates, an increase in N-acetyl-beta-D-glucosaminidase (NAG) enzymuria and renal tubulointerstitial damage by day 14. These changes were associated with a 5-6-fold increase in urinary thromboxane B2 excretion (from pretreatment values of 28...
March 24, 1993: Biochemical Pharmacology
J D Blachley
Dietary factors may have substantial impact on the clinical manifestations and even the progression of chronic renal failure. Proper dietary management can prevent certain uremic complications, decrease azotemia, and may even prevent the loss of residual renal function. Recent studies indicate that dietary protein may accelerate the normal age-related deterioration of renal function in rats. The extensive ablation of functional renal mass in rats leads to hyperemia and hyperfiltration in remnant nephrons. Continued hyperfiltration theoretically results in glomerular damage, proteinuria, and ultimately glomerular sclerosis...
December 1984: American Journal of the Medical Sciences
M Walser
No abstract text is available yet for this article.
October 1990: Kidney International
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