46 patients with III-IV staged CKD caused by systemic diseases (33 - by systemic lupus erythematosus and 13 – different systemic angiitis), were randomised to 3 groups: 1st - 18 patients (10 with III and 8 with IV stages) – during observational time (24-48 months) got LPD (0,6 g protein kg/day) with balanced content of essential amino- and ketoacids; 2 nd - 18 patients (10 with III and 8 with IV stages) – got LPD as well, but with increased level of plant protein till 0,3 g/kg/day owing to high-purity soy protein in the content of high-energetic nutrition mix; 3d – 10 patients (7 with III and 3 with IV stages) – control group – free diet. Both variants of LPD was prescribed to all patients of 1 and 2 groups without difference due to nutritional status. Nutritional status was evaluated on the basis of anthropometrical and some other standard parameters. Protein intake and food calories was counted according to 3-days food diery. Among 46 patients with systemic diseases and III-IV staged CKD nutritional status disorders were found almost at half (45,7%). Both variants of LPD were well tolerated, as a result of their use correction of nutritive disorders was achieved at patients that previously had them, and the prevention of nutritive disorders was got at the rest of the patients of 1 and 2 groups. In 3 group we found the increased frequency of nutritional status disorders with the progression of renal failure by 1,5 times (from 40% to 60%). At patients who took LPD not less than 1 year, we found slowing of GFR decrease, that was more significant with the use of high-energetic nutrition mix. Conclusion Early (at the stage before dialysis) protein intake constriction (0,6 g/kgг/day) with content in the diet of essential amino- and ketoacids and high-energetic nutrition mix has beneficial effects on nutritive status of patients with CKD and leads to slowing of GFR decrease.

Keywords: ketoacids, essential aminoacids, nutritional status disorders, systemic diseases, chronic kidney disease