Information for Dietitians
Click below to view 4 short videos presented by Dr. Elizabeth Sussman PhD RD, Associate Professor of Nutrition and Dietetics specializing in renal nutrition and research, reviewing clinical data on the use of low protein diets supplemented with keto-analogues as a tool to slow the progression of CKD and maintain nutrition.
About KetorenaKetorena is a keto-acid analogue of essential amino acids (keto-analogue) used to maintain or improve nutrition and slow the progression of CKD for those on a low or very low protein diet.
Each dose of Ketorena contains 2100 mg or 2.1g of Keto & Amino Acids.
Ketorena DosingThe starting dose of Ketorena is 1 scoop 3 times daily when initiating a low protein diet. Maintenance dosing for Ketorena is individualized based on the level of protein restriction and patient body weight.
Please review the dosing and treatment protocol below from the IKABM. The dosing recommendations are to initiate a keto-analogue at 0.1g/kg BW/day.
A patient weighing 60kg would then take 0.1g x 60 = 6g or 6000mg. 1 scoop of Ketorena = 2100mg or 2.1g. 3 scoops = 6300mg or 6.3g. The dose would then be 1 scoop 3 times daily.
Keto-Acid AnaloguesThe use of keto-analogues in combination with a low or very low protein diet is widely used for managing CKD in Europe, Asia and other parts of the world. Keto-analogue use has been limited in the United States because of its lack of availability here.
When used with appropriate diet, keto-analogues have been shown to reduce CKD progression, slow the onset of uremic symptoms, and improve nutritional parameters and markers. Please see the section below titled: "Recent clinical Data on the use of keto-analogues with LPD/VLPD" for clinical references and further information.
Keto-acid analogues of essential amino acids provide potential advantages for CKD patients. Ketoacids lack the amino group bound to the alpha carbon of an amino acid so they can be converted to their respective essential amino acids without providing additional nitrogen.
Patient types who may benefit from a low or very low protein diet supplemented with Ketorena:
The 2020 KDOQI Clinical Practice Guideline For Nutrition in CKD. Guideline 3 Protein and Energy Intake.
Protein Restriction, CKD patients not on dialysis and without diabetes
Low protein diet or very low protein diet supplemented with a keto-analogue
Considerations of metabolically stable
In the context of these recommendations, metabolically stable indicates:
Find the full guideline here: KDIGO 2020 Nutrition in CKD guideline
The following beneficial effects may be found with a keto-analogue supplemented protein restricted diet:
The International Keto Analogue Board Meeting consensus statement on the