A Metabolic and Economic Rationale Forketo Acid in CKD

-Chronic kidney disease (CKD), characterized by sustained kidney damage and/or reduced kidney function, is prevalent and is associated with substantial morbidity and mortality. While end- stage renal disease (ESRD), which is defined by the requirement of dialysis or transplant to sustain life, is a well-known debilitating and expensive outcome of CKD, most adults with CKD will never progress to ESRD. Need strategy should be used to avoid progress to ESRD. Restriction of dietary protein intake has been a relevant part of the management of CKD for more than 100 years, but even today, the principal goal of protein-restricted regimens is to decrease the accumulation of nitrogen waste products, hydrogen ions, phosphates, and inorganic ions while maintaining an adequate nutritional status to avoid secondary problems such as metabolic acidosis, bone disease, and insulin resistance, as well as proteinuria and deterioration of renal function. Protein-restricted (keto/amino acid-supplemented) dietary regimens, have been used for decades to alleviate uremic symptoms, to prevent complications such as metabolic acidosis and renal osteo??dystrophy, as well as to improve complications such as abnormal glucose metabolism and hypertension in patients with advanced CKD. There is also clinical trial evidence to suggest that protein- restricted diets can slow the rate of progression in patients with CKD and/or the occurrence of renal death in those with predialyti