Biofizpribor, Special Design and Technological Bureau, Branch of FMBA of Russia, St. Petersburg, Russia
With uremia, it becomes necessary to reduce the nitrogen level in the diet while maintaining the satisfaction of the human body's need for essential amino acids. In this regard, the latter are replaced in the diet with the corresponding α-keto acids or α-hydroxy acids that are in equilibrium with them, in the expectation that keto acids will turn into amino acids during transamination. However, some essential amino acids are not replaced by the corresponding α-keto and hydroxy acids and are administered unchanged. The article discusses the possibility of replacing 10 essential amino acids with α-keto- and hydroxy analogues in the diet of uremic patients, of which 2 are nonessential for healthy people. The substitution base of each amino acid by its analogue is analyzed. Recommendations on providing patients with threonine and methionine are given. Since nephropathies can be of diabetic origin, each amino acid is also analyzed for glucogenic or ketogenic effects. The presence of the latter is recognized as the basis for limiting the introduction of this amino acid and its α-keto or hydroxy analogue.

Keywords: ketogenic action, glucogenic action, essential amino acids, transamination