Therapeutic Dose of Alpha-Ketoglutarate
For critically ill ICU patients requiring parenteral nutrition, the therapeutic dose of L-glutamine (which is metabolized to alpha-ketoglutarate) is 0.2-0.4 g/kg/day, typically administered as 0.3-0.6 g/kg/day of alanyl-glutamine dipeptide. 1
Clinical Context and Dosing
The question appears to reference alpha-ketoglutarate (αKG), which is distinct from alpha-ketoglutaramate. Based on available clinical evidence:
For Critically Ill Patients (ICU Setting)
- Standard dose: 0.2-0.4 g/kg/day of L-glutamine (equivalent to 0.3-0.6 g/kg/day alanyl-glutamine dipeptide) when added to parenteral nutrition 1
- Absolute dose range: 10-30 g glutamine per 24 hours has been safely tolerated in critically ill patients and shown to restore plasma levels 1
- Studies demonstrating clinical benefit used doses ranging from 0.2 to 0.57 g/kg/day of glutamine 1
For Acute Pancreatitis
- Recommended dose: Greater than 0.20 g/kg/day of L-glutamine (greater than 0.30 g/kg/day Ala-Gln dipeptide) should be considered 1
- This dosing showed reduced complication rates and shorter hospital stays in randomized trials 1
For Type 2 Diabetes (Experimental)
- Experimental dose: 8 mg/100 g body weight daily (approximately 5.6 mg/kg/day in mice) reduced platelet and leukocyte activation and inflammatory markers 2
- This represents a significantly lower dose than used in critical care settings and requires further human validation 2
Safety Profile
- No harmful effects have been documented with intravenous L-glutamine or dipeptide supplementation in critically ill patients at the recommended dose ranges 1
- Glutamate toxicity concerns have not been substantiated, even in head trauma patients 1
- Continuous renal replacement therapy may increase glutamine loss by 4-7 g/day, potentially requiring higher supplementation 1
Important Caveats
Alpha-ketoglutaramate vs. alpha-ketoglutarate: These are different compounds. Alpha-ketoglutaramate is a deaminated metabolite of glutamine that accumulates pathologically in hepatic coma (not a therapeutic agent) 3, while alpha-ketoglutarate is a Krebs cycle intermediate with potential therapeutic applications 2.
The evidence base for therapeutic alpha-ketoglutarate supplementation in humans remains limited, with most robust dosing data coming from glutamine supplementation studies in critical care settings where glutamine serves as a precursor to alpha-ketoglutarate 1.