Ketosteril (L-Lysine Acetate, L-Tryptophan, L-Histidine, L-Threonine, L-Tyrosine, Keto-Isoleucine Calcium, Keto-)

Ketosteril is used in renal nutrition to manage protein metabolism in chronic kidney disease.

• Chronic kidney disease: helps reduce nitrogen accumulation and supports dietary protein restriction.
• End‑stage renal disease: provides essential amino acid precursors when dialysis is required.
• Renal failure: assists in maintaining nutritional status while limiting uremic toxins.
• Dietary protein restriction in CKD: supplies keto‑analogues that can be transaminated, allowing lower protein intake.
• Pre‑dialysis management: supports nitrogen balance before initiation of dialysis.

• Ketosteril provides keto‑analogues of essential amino acids that are taken up by cells and transaminated using nitrogen from non‑essential amino acids, forming the corresponding essential amino acids. This process supplies necessary amino acids without adding nitrogen load, thereby decreasing uremic toxin generation and supporting protein synthesis in patients with reduced renal function.

Ketosteril may be associated with several adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea
• Vomiting
• Abdominal discomfort
• Loss of appetite
• Mild headache
• Metallic taste

Serious or Rare Side Effects

• Hyperkalemia
• Metabolic acidosis
• Allergic reaction (rash, pruritus)
• Hepatic dysfunction
• Severe gastrointestinal bleeding
• Anaphylaxis

When using Ketosteril, certain precautions should be observed to ensure safety.

• Dose adjustment: required in severe hepatic impairment.
• Monitor serum electrolytes: especially potassium and phosphorus.
• Avoid in patients with known hypersensitivity to any component.
• Use caution in pregnant or breastfeeding women: risk unknown.
• Store at ambient temperature: keep in original container, protect from moisture and light.

Ketosteril can interact with other medicines; awareness of major and moderate interactions helps prevent complications.

Major Interactions (Avoid)

• Concurrent high‑dose potassium supplements: may exacerbate hyperkalemia.
• Use with nephrotoxic drugs (e.g., aminoglycosides): increased renal stress.
• Co‑administration with other nitrogen‑loading amino acid supplements: counteracts intended effect.

Moderate Interactions (Monitor Closely)

• Diuretics: may alter electrolyte balance.
• ACE inhibitors or ARBs: monitor potassium levels.
• Antacids containing aluminum or magnesium: may affect absorption.