Double-blind cross-over study with oral alpha-ketoacids in patients with chronic renal failure.

In 15 ambulatory patients with renal insufficiency (creatinine clearance, 9.9 +/- 3.0 ml/min) the effect of oral supplementation with alpha-ketoacids has been compared with that of placebo. The protein intake amounted to 0.55 g protein per kilogram body weight of high biological value, as estimated by dietary recordings. After a control period of 3 months the patients received, in a double-blind study, 1.05 g alpha-ketoacids/10 kg body weight per day or a placebo for 6 weeks with a subsequent cross-over. Fasting blood samples were analyzed at 3-week intervals for routine laboratory parameters and 17 proteins. Anthropometric and clinical data have been recorded every 3 weeks. While therapy with alpha-ketoacids diminished PO4 levels (P less than 0.05), no other significant effect could be demonstrated. No signs of protein deficiency existed either before or during alpha-ketoacid therapy. Therefore, supplementation with alpha-ketoacids appears to be superfluous in patients with renal insufficiency maintained on a 40-g protein diet.