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Is there a medical alternative to dialysis?

Friday, 26 September 2003
Answered by: Naveen Atray
Asst Professor of Medicine and Nephrologist
Overton Brooks VA Medical Centre, USA
USA
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Q. My father aged 53 years is suffering from bilateral polycystic kidney disease. His blood urea and creatinine is 95 and 7.7 respectively. He has swelling in both his legs and feels terribly tired after taking a short walk. He maintains the blood pressure level at 130/80 after taking the requisite drugs. Of late, he has been prescribed a medicine called Ketosteril (6 tablets daily). How far is the drug effective, since he is taking the drug for the last 50 days but there has been no sign of improvement as yet. Does the use of the said drug help avoid dialysis? If yes, for how long shall he continue with the drug? Please advise.

A.  It has been suggested that the use of ketoacid supplement (which are nitrogen free amino acids) may slow the progression of kidney disease. This effect has been believed, by some, to be due to their antioxidant effect rather than lack of nitrogen. One small study demonstrated that consumption of ketoacid (like Ketosteril) may have some benefit but another larger study demonstrated lack of its benefit. Since it is not known to cause any harm, I will not recommend not to take it. However, the lab tests of your father indicate that his kidney disease is fairly advanced and beyond any repair. Thus, he will not benefit from this medicine. I do suggest that he needs to be started on dialysis without any further delay as you have indicated from his symptoms as well.

A.  It has been suggested that the use of ketoacid supplement (which are nitrogen free amino acids) may slow the progression of kidney disease. This effect has been believed, by some, to be due to their antioxidant effect rather than lack of nitrogen. One small study demonstrated that consumption of ketoacid (like Ketosteril) may have some benefit but another larger study demonstrated lack of its benefit. Since it is not known to cause any harm, I will not recommend not to take it. However, the lab tests of your father indicate that his kidney disease is fairly advanced and beyond any repair. Thus, he will not benefit from this medicine. I do suggest that he needs to be started on dialysis without any further delay as you have indicated from his symptoms as well.

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