Abstract | BACKGROUND: PATIENTS AND METHODS: In a long-term prospective double-blind placebo-controlled randomized trial, we evaluated for a period of 36 months a total of 111 CKD patients (54 men, 57 women) aged 22-76 years with obesity (BMI >or= 30 kg/m(2)) and an inulin clearance rate (C(in)) of 22-40 ml/min/1.73 m(2). All patients were on a low-protein diet containing 0.6 g protein/kg BW per day and 120-125 kJ/kg BW per day. The diet was randomly supplemented with keto- amino acids at a dosage of 100 mg/kg BW per day (66 patients, Group I); 65 patients received placebo (Group II). RESULTS: During the study period, the glomerular filtration rate decreased slightly in Group I (C(in) from 32.4 +/- 12.6 to 29.8 +/- 8.6 ml/min/1.73 m(2)) and more markedly in Group II (from 33.2 +/- 12.6 to 23.2 +/- 98.4 ml/min/1.73 m(2), P < 0.01). BMI decreased significantly in Group I (from 32.0 +/- 3.3 to 26.1 +/- 4.0 kg/m(2), P < 0.01) and was linked to reduced volume of visceral fat measured by MRI (P < 0.01). Reduction of BMI in Group II was not significant. In Group I, there was a significant decrease in the plasma level of ADMA (from 2.5 +/- 0.5 to 1.3 +/- 0.4 micromol/l, P < 0.01), but ADMA remained unchanged in Group II. A further remarkable finding in Group I was reduction in the plasma concentration of pentosidine (from 480 +/- 170 to 320 +/- 120 microg/l, P < 0.01) and decrease of proteinuria (from 3.8 +/- 2.24 to 1.6 +/- 1.0 g/24 h, P < 0.02). Plasma adiponectin rose in Group I (P < 0.01). Analysis of the lipid spectrum revealed a mild but significant decrease in total cholesterol and LPD- cholesterol (P < 0.02), more pronounced in Group I. There was also a decrease in plasma triglycerides in Group I (from 3.9 +/- 1.6 down to 2.2 +/- 0.6 mmol/l, P < 0.01) and a decrease in glycated hemoglobin (from 7.2 +/- 1.4% to 4.2 +/- 0.8%, P < 0.02). CONCLUSION:
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Authors | Vladimir Teplan, Otto Schück, Jaroslav Racek, Olga Mareckova, Milena Stollova, Vladimir Hanzal, Jan Malý |
Journal | Wiener klinische Wochenschrift
(Wien Klin Wochenschr)
Vol. 120
Issue 15-16
Pg. 478-85
( 2008)
ISSN: 0043-5325 [Print] Austria |
PMID | 18820852
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Amino Acids
- Keto Acids
- N,N-dimethylarginine
- Arginine
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Topics |
- Adult
- Aged
- Amino Acids
(administration & dosage)
- Arginine
(analogs & derivatives, blood)
- Combined Modality Therapy
- Diet, Protein-Restricted
(methods)
- Dietary Supplements
- Female
- Humans
- Keto Acids
(administration & dosage)
- Kidney Failure, Chronic
(blood, drug therapy)
- Male
- Middle Aged
- Obesity
(blood, drug therapy)
- Treatment Outcome
- Young Adult
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