Sp341influence of Essential Amino Acids Ketoanalogs and Protein Restriction to Morphogenetic Proteins (Fgf-23 and Soluble Klotho) in CKD Patients

Disorders in the System of Mineral and Bone Metabolism Regulators—FGF-23, Klotho and Sclerostin—in Chronic Kidney Disease: Clinical Significance and Possibilities for Correction

“…In addition, according to our data, in patients with CKD 3B-4 stages using of LPD (0.6 g protein per kg body weight/day) supplemented with calcium salts of keto acids, it was possible to achieve and maintain the target level of serum phosphorus and calcium by using lower doses of phosphate-binding drugs, compared with the patients who used LPD, but did not take keto/amino acids [51,52].…”

“…According to the results of our study [52], the use of Low Protein Diet (LPD) in combination with keto/amino acids, during not less than 12 months, in patients with 3B-4 stages of CKD, can prevent the development of nutritional status disorders, as well as stimulate sKlotho expression and suppress FGF-23 production. In addition, in these group patients, impairment of vascular damping function (according to the assessment of pulse wave velocity and augmentation indices by «SphygmoCor» device) as well as cardiac (by EchoCG, semiquantitative scale) and aorta calcification (by Kauppila method), and the formation of LVH, was less common.…”

“…The appearance preliminary results of few clinical trials indicate the possibility of influencing traditional renoprotective therapy such as early correction of arterial hypertension, anaemia, Chronic Kidney Disease -from Pathophysiology to Clinical Improvementshyperphosphatasemia and nutritional status disorders on the maintenance of Klotho protein synthesis and FGF-23 overproduction suppression [51][52][53].…”

Nutritional Status Disorders in Chronic Kidney Disease: Practical Aspects (Systematic Review)

“…LPD in combination with EAA and KA enhances the following positive effects: antihypertensive and antiproteinuric effects of RAAS blockers, the corrective effect of erythropoietin preparations on anemia and of synthetic analogs of vitamin D, calcimimetics on hyperparathyroidism, and also the hypolipidemic effect of statins [1,13,14] At the same time, CKD patients, with combined administration of EAA and active metabolites of vitamin D, due to a possible risk of hypercalcemia should stop taking vitamin D. If hypercalcemia persists, then it is necessary to reduce the dose of EAA to normalize the plasma concentration of calcium [1]. In recent years, the effect of ketosteril on the risk of vascular calcification has not been confirmed [29].…”

“…LPD with an addition of soy protein to the diet reduces tubulointerstitial fibrosis also due to suppression of tyrosine protein kinase as a powerful sclerosis stimulant [30]. Currently, the possibility of LPD influence to maintain the serum level of klotho protein, as an established strong early cardio and nephroprotective factor, is being actively studied [29].…”