Ketoanalogues of amino acids (KAs) are nitrogen-free analogs of essential amino acids. Studies have demonstrated that the benefits of ketoanalogues (KA) supplementation on mortality and renal outcomes in CKD patients undergoing dietary protein restriction are controversial [,,,,]. The effects of KA on patients with advanced CKD with an Low Protein Diet (LPD) are unclear [,,,]. Basically, the ketoanalogues help to prevent protein wasting and deficiencies.

In the human body, ketoanalogues capture nitrogen and convert it into amino acids, which are the building blocks of protein. Providing ketoanalogues like Ketosteril prevents malnutrition because the body is still able to build protein. In addition, because ketoanalogues use excess nitrogen, the kidneys do not have to work as hard to excrete nitrogen-containing waste. This may slow the progression of chronic kidney disease and postpone dialysis.

Till date, the effects of KA on advanced CKD patients with DM have not been examined yet through randomized controlled trials. In a 2020 study, KA supplementation increased the risk of long-term dialysis in the subgroup of advanced CKD patients with DM but not in the subgroup of advanced CKD patients without DM. 


Ketosteril is a calcium-based ketoanalogue. It includes the following ingredients:

  • Calcium-3-methyl-2-oxovaleric acid
  • Calcium-methy-2-oxovaleric acid
  • Calcium-2-oxo-3-phenylpropionic acid
  • Calcium-3-methyl-2-oxobutyric acid
  • calcium-DL-2-hydroxy-4-(methylthio)-butyric acid
  • L-lysine acetate
  • L-threonine
  • L-tryptophan
  • L-histidine
  • L-tyrosine

Other ingredients include corn starch, crospovidone, povideone, talc, highly dispersed silicon dioxide, magnesium stearate, macrocol 6000, colouring agents E104, E171 alkaline polymethacrylate, glycerol triacetate.

The total nitrogen content per tablet is about 36 milligrams. Total calcium content is 0.05 grams.