Ketoanalogues of Essential Amino Acids

How it works

The keto- and hydroxy-acid analogues are transaminated into their corresponding essential amino acids by incorporating circulating nitrogen, allowing protein synthesis while reducing the production of nitrogenous waste.

Prescribing in practice

• It must be used together with an adequately energy-supplied low-protein diet and is unsuitable where dietary protein or energy intake cannot be assured.
• Serum calcium should be monitored, as the preparation contains calcium and hypercalcaemia can occur.
• It is contraindicated in disorders of amino acid metabolism and in hypercalcaemia.

Monitoring

Monitor serum calcium and overall nutritional and renal parameters during treatment.

Counselling the patient

• Take with meals and adhere to the prescribed low-protein, adequate-energy diet.
• Attend dietitian and blood test appointments as arranged.
• Report symptoms such as nausea, confusion or excessive thirst.

Evidence & guidelines

Ketoanalogue-supplemented low-protein diets are used to help control uraemic symptoms and may slow progression in selected chronic kidney disease patients.