[Controlling renal osteopathy with keto acids].

Starting from the results of former investigations the influence of the long-term treatment with the KA of the essential amino acids on the renal osteopathy is investigated. For this purpose we compared 27 patients with renal insufficiency (serum creatinine 981 +/- 354 mumol/l), who besides vitamin D had been treated with KA for at least 12 months, to a group of 50 patients (serum creatinine 778 +/- 273 mumol/l), who had received vitamin D over 19 +/- 9 months, and to a control group of 27 patients (serum creatinine 928 +/- mumol/l) without an adequate conservative therapy. While the control group showed the typical constellation in advanced renal insufficiency with hypocalcaemia, hyperphosphataemia, clearly increased PTH levels, clearly increased CT values and normal 25-OH-D concentrations, during the diettherapy and the vitamin D substitution a significant increase of the serum levels of calcium, 25-OH-D and CT as well as a significant decrease of the PTH and the anorganic phosphate in the serum developed. Under the combination therapy with KA and vitamin D despite the reduction of the phosphate binders another significant decrease of the PTH and the anorganic phosphate was observed. The mineral content of the bones was within the normal in the two therapy groups. The percentage of the normal histological findings of the bones was with 40.7% highest despite the advanced renal insufficiency in the simultaneous substitution with KA. While in the vitamin D group during the control biopsy after 12 months in 20.5% of the cases an improvement of the histological findings developed, this effect occurred under additional KA-therapy in 51.9% of the cases. The results allow the conclusion that by means of the long-term treatment with KA a favourable influence on the renal osteopathy develops.