Ketoanalogue Tablet Dosage
The standard dosage of ketoanalogue supplementation is 1 tablet per 5 kg of body weight per day, typically administered in divided doses with meals. 1, 2
Standard Dosing Protocol
The recommended dose is 1 tablet per 5 kg body weight daily (e.g., a 70 kg patient would receive approximately 14 tablets per day), administered alongside a very low protein diet of 0.3-0.4 g/kg/day 1, 2
Ketoanalogues should be taken with meals to optimize absorption and utilization, distributed throughout the day rather than as a single dose 1
This dosing regimen is specifically designed for patients with advanced chronic kidney disease (CKD stage 4-5) who are following a protein-restricted diet 1, 3
Evidence-Based Dosing Thresholds
A minimum daily dosage of more than 5.5 tablets is required to achieve significant clinical benefit in reducing the risk of dialysis initiation and mortality in patients with anemic advanced CKD 4
Dosages ranging from 6 to 14 g daily (as sodium or calcium salts) have been studied in severe chronic uremia, with higher doses used for patients with more advanced disease 5
The preparation typically contains ketoanalogues of valine, leucine, isoleucine, methionine, and phenylalanine, along with remaining essential amino acids 5
Clinical Context and Monitoring
Ketoanalogue supplementation must be combined with strict protein restriction (0.3-0.6 g protein/kg/day) and adequate caloric intake to be effective 1, 3
This therapy is appropriate for motivated stage 4-5 CKD patients without severe comorbid conditions, representing approximately 30-40% of the concerned population 3
Regular monitoring by both physicians and dietitians is essential to ensure nutritional status is preserved and to adjust dosing based on clinical response 3
Important Caveats
Ketoanalogues are most effective when introduced before end-stage renal failure (plasma creatinine <700 μmol/L or approximately 8 mg/dL), as patients with very advanced disease may respond less favorably 2
Approximately 50% of patients demonstrate satisfactory adherence to this dietary prescription, which is critical for therapeutic success 3
The therapy requires adequate caloric intake to ensure ketoanalogues are utilized for protein synthesis rather than being oxidized for energy 1, 5
No accumulation of ketoacids in plasma or urine has been detected at these dosages, and the treatment is generally well tolerated without significant toxicity 5, 2