Considered effective on patients with chronic kidney disease (CKD) of stage II and III, the new therapy is used in pre-dialysis stage and is said to slow down the disease and delay starting of dialysis by few years — depending on the patient. The diet tablets made up of special amino acids, the building blocks of all proteins, are minus nitrogen that accelerates disease’s progression.

“Nitrogen in proteins helps progression of CKD. Hence there should be less nitrogen in the patient’s diet. However, this protein restriction leads to malnutrition, which worsens a patient’s general condition and can even threaten survival. This therapy provides necessary amino acids without a corresponding ‘nitrogen load’,” said professor William Mich of University of Texas. Furthermore, keto acids not only substitute respective amino acids and maintain nitrogen balance, but also exert other desirable effects on the overall metabolism of the body. The first clinical report in this regard was published by Mackenzie Walser and William Mitch in the US in late 70’s.

Even though this therapy works wonders in the West where there is a high amount of protein in the daily diet, Indian nephrologists are doubting the efficacy of the therapy in India. “Keto Acid therapy is part of the other measures to be followed to prolong dialysis and transplant. Even though it is proven effective on a very small set of patients, it is not a panacea for CKD. Protein-restricted Keto Acid Therapy backfires in malnourished patients. Hence it has a questionable benefit on Indian patients as most of them are malnourished,” said Dr Umesh Khanna, consultant nephrologist attached to the Asian Heart Hospital.

However, Dr Khanna agrees that a small number of patients — a section of the early-diagnosed patients — are benefited by the therapy.

Prof Mich, too, warns that it is not advisable to start the therapy on pregnant women with kidney problems or polycystic kidney disease patients. The therapy is mainly dietary based hence there are not many side effects except for stomach upset.