Study On The Effect Of α -ketoacids Formulations On CRF Patients

Nutritional therapy for chronic renal failure is a very important field in kidney research. Proper nutritional management with renal patients can not only improve clinical symptoms and signs , but also slow down the progression of renal failure.then bring life of high quality to the patients.Many clinical trials show: a very low protein diet supplemented with α-ketoacids formulation can maintain nitrogen balance, improve nutritional status of patients with and without dialysis, reduce toxic nitrogen metabolites, retard the progression of renal failure, prolong the period without dialysis and decrease the mortality and morbidity. Meanwhile ketoacids formulations with different proposition of components may have different treatmental effects.At present, Ketosteril is a generally used α-ketoacids formulation in China, its proposition of amino acids and a -ketoacids is based on the proposals of Rose for normal young adults and designed according to that of potato and egg, But it does not take into consideration the special requirements of uremic patients, Since studies suggest that requirement of amino acids for normal subjects is different from that of patients with CRF , and important benefits can be derived from the proper design of an amino acid/analogue supplement for CRF patients.Therefore we try to find some α -ketoacids formulations proper for Chinese patients according to data from home and abroad.Our study can be divided into four parts:(1)Quantitation of branched-chain ketoacids in plasma by gas chromatography chemical ionization mass spectrometry of o-trimethylsilyl-quinoxalinol derivatives, after derivatization with o-phenylenediamine in acidic medium and extraction,the ketoacids are silylated and resolved on a capillary column and their concentrations automatically determined by monitoring the m/z values corresponding to their respective protonated molecular ions, the detection limit is 100ng/ml and there is no interference in plasma, it is a reliable method with considerable precision and accuracy; we also determine the plasma concentration of branched-chain keto acids in both CRF patients and healthy controls, compare the pharmacokinetic parameters in both CRF patients and healthy controls after an oral dose of ketosteril, the results show fasting plasma...