Have you heard of ketoanalogue supplements? Physicians and registered dietitians recommend them for some chronic kidney disease (CKD) patients, but they are not for everyone. Learn more about what ketoanalogues are, when they should be taken, and their potential benefits.* 

What are ketoanalogues?

Ketoanalogue supplements are a form of amino acids (the building blocks of protein) without nitrogen. This can be helpful for CKD patients as a build-up of nitrogen can be harmful and progress kidney disease. Nitrogen build-up is often identified in bloodwork as part of a person’s blood urea nitrogen (BUN) test. 

When should you take ketoanalogues?

Ketoanalogues are most often used in stages 3-5 CKD, prior to starting dialysis, but they are not the first line of defense. According to renal dietitian Jen Hernandez RDN, CSR, LDN, other nutritional interventions that should be taken first to slow the progression of CKD include:

• Low protein diet
• Low sodium diet
• Blood sugar control and management

If kidney function continues to decline or has a sudden drop during these interventions, you may be recommended to take ketoanalogues. 

When should you not take ketoanalogues?

Ketoanalogues are not beneficial for everyone, including patients who have: 

• Healthy kidneys 
• High levels of calcium or magnesium in their blood (determined by a blood test)
• Been told by their doctor not to take them 

What are the potential benefits? 

There have been numerous studies on the potential benefits of ketoanalogues in CKD. Some of the benefits include:

• Slowing kidney function decline
• Improving blood levels associated with CKD – serum creatinine, BUN, phosphorus, and parathyroid hormone levels
• Decreasing metabolic acidosis
• Decreasing insulin resistance
• Improving blood pressure
• Decreasing proteinuria (protein in the urine)
• Delaying having to start dialysis

What are the types of ketoanalogues available? 

There are a few different ketoanalogue brands on the market. Each one has a different combination of amino acids, dosing instructions, and costs. Three types you can find on the market include:

• Ketorena is calcium-based and sold in both a powder and tablet form.
• Albutrix is magnesium-based and is currently available in tablet form only.
• Ketosteril is calcium-based, requires a doctor’s prescription, and is available in tablet form only.

Unfortunately, ketoanalogues are not covered by insurance and can be pricey. At a minimum, the cost of a one-month supply is $100 a month. 

Should I start taking ketoanalogues? 

It is very important to speak with your healthcare team before starting a ketoanalogue supplement. Your team will need to check and monitor your kidney-related labs to see if taking the supplement is safe and effective for you. In addition, a renal (kidney) dietitian can help to ensure that you consume a safe and appropriate amount of protein while on the supplement. 

Ketoanalogues may be beneficial to your kidney health but can lead to worsening kidney function if taken irresponsibly and without supervision. 

*Hernandez, J. (2021, July 13). Ketoanalogues: How This Medical Food Can Keep Kidney Function. Plant-Powered Kidneys | Renal Diet for Kidney Health. Retrieved March 22, 2023, from https://www.plantpoweredkidneys.com/ketoanalogues/