CKD Stage 3 and Ketosteril

Chronic Kidney Disease (CKD) Stage 3 is a renal condition with symptoms or asymptomatic, depending on severity.

1. reduced clearance of urea and creatinine from blood into urine. 
2. Blood urea and creatinine exceed normal levels. 
3. Urine output can be none, little (oliguria) or normal. 
4. The patient has uremia with nausea. 
5. The patient may feel lousy at times, 
6. tired at times, 
7. loss of appetite at times, and 
8. fatigued at times. 
9. Depression may begin to seep in as the patient learns of his/her worsening condition, while doctors try to figure out the best treatment regime for the patient's failing kidney(s) or renal function/system.

Protein intake becomes important in CKD. Controlling protein intake in the diet is not so easy to do. It is easier said than done in the home setting. A protein restricted diet (40 g protein/day) contains protein the size of a match-box. That is not much for a 70 kg patient. The patient will start feeling hungry very easily.

There are options which researchers have worked on.

1. Low protein intake
2. Restricted animal protein
3. Vegetarian protein
4. Vegetarianism

To reduce dietary protein intake and yet maintain amino acid metabolism, a ketoanalogue can be used.

1. Ketosteril is a ketoanalogue of creatinine. 
2. Ketosteril will reduce blood creatinine levels and save the kidney(s), giving the kidney(s) time to recover. However, CKD can still progress, but slower.
3. Ketosteril is prescribed for pre-dialysis stable CKD patients. 
4. It is prescribed for CKD Stage 5. 
5. However, it can be prescribed for stable CKD Stage 2 and Stage 3.

Use of Ketosteril comes with its dangers. There are safety guidelines for using Ketosteril. Some doctors will prescribe 2 tablets 3x a day. Without a doctor's prescription, patients may take more tablets per day. Refer to pharmacy.

Government hospitals and university hospitals do not supply Ketosteril FOC. Patients have to purchase Ketosteril on their own, from pharmacies. The cost varies widely, from RM250 to RM280 per 100 tablets.

External links

"Ketosteril® - Fresenius Kabi India." Fresenius-kabi.com. N. p., 2019. Web. 4 Mar. 2019.

Tzekov VD, et al. (2000). Low protein diet and ketosteril in predialysis patients with renal failure. Folia Med (Plovdiv). 2000;42(2):34-7. PubMed - NCBI . Ncbi.nlm.nih.gov. Retrieved 4 March 2019, from https://www.ncbi.nlm.nih.gov/pubmed/11217281

J, B. (1984). Discovery and rediscovery of low protein diet. Clin Nephrol. 1984 Jan;21(1):29-35. PubMed - NCBI . Ncbi.nlm.nih.gov. Retrieved 4 March 2019, from https://www.ncbi.nlm.nih.gov/pubmed/636806

Gluba-Brzózka, Anna, Beata Franczyk, and Jacek Rysz. "Vegetarian Diet In Chronic Kidney Disease—A Friend Or Foe." Nutrients 9.4 (2017): 374. Web. 4 Mar. 2019.