{"product_id":"ketosteril-tablets-100s","title":"Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic Kidney Disease","description":"\u003cdiv style=\"background: #f8f9fa; border-left: 4px solid #0057a8; padding: 12px 16px; margin-bottom: 20px;\" id=\"ai-summary\"\u003e\n\u003cstrong\u003eClinical Summary:\u003c\/strong\u003e Fresenius Kabi Ketosteril is a film-coated oral tablet containing five essential amino-acid alpha-ketoanalogues (as calcium salts) and five essential L-amino acids (lysine, threonine, tryptophan, histidine, tyrosine), delivering 36 mg total nitrogen and 50 mg (1.25 mmol) elemental calcium per tablet. It is indicated for the prevention and treatment of consequences of faulty or deficient protein metabolism in chronic renal insufficiency, used in combination with a very-low-protein diet (VLPD, approximately 0.3-0.4 g\/kg\/day) in adults with glomerular filtration rate below 25 ml\/min. Each pack contains 100 tablets. Registered by Singapore HSA.\u003c\/div\u003e\n\u003ch2\u003eProduct Overview\u003c\/h2\u003e\n\u003cp\u003eKetosteril is a nitrogen-free amino-acid analogue product that enables nephrologists to prescribe a very-low-protein diet (VLPD) in pre-dialysis chronic kidney disease (CKD) without inducing protein-energy wasting. The formulation provides ketoanalogues of isoleucine, leucine, phenylalanine, valine and methionine, which are transaminated in vivo using circulating urea-derived nitrogen to regenerate the parent amino acids. This transamination pathway effectively recycles nitrogen that would otherwise accumulate as uraemic toxins, reducing the symptomatic burden of uraemia while preserving nutritional status on a restricted protein intake.\u003c\/p\u003e\n\u003cp\u003eEvidence from the Modification of Diet in Renal Disease (MDRD) study and subsequent meta-analyses (Cochrane Review: Rughooputh et al., 2015; Bellizzi et al., Nephrol Dial Transplant 2018) supports the use of VLPD supplemented with ketoanalogues to slow the decline in glomerular filtration rate, delay dialysis initiation, and attenuate metabolic acidosis and hyperphosphataemia in stage 4-5 CKD. For Singapore nephrologists, renal dietitians, and clinic pharmacies managing the growing pre-dialysis population, Ketosteril is a KDIGO-relevant nutritional intervention where VLPD is clinically appropriate.\u003c\/p\u003e\n\u003ch2\u003eSpecifications\u003c\/h2\u003e\n\u003ctable style=\"border-collapse: collapse; width: 100%;\" cellspacing=\"0\" cellpadding=\"6\" border=\"1\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eManufacturer\u003c\/th\u003e\n\u003ctd\u003eFresenius Kabi\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eDosage Form\u003c\/th\u003e\n\u003ctd\u003eFilm-coated oral tablet\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003ePack Size\u003c\/th\u003e\n\u003ctd\u003e100 tablets per container\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eKetoanalogue Content (per tablet)\u003c\/th\u003e\n\u003ctd\u003e(RS)-3-methyl-2-oxovaleric acid (ketoanalogue of DL-isoleucine) calcium salt 67 mg; 4-methyl-2-oxovaleric acid (ketoanalogue of leucine) calcium salt 101 mg; 2-oxo-3-phenylpropionic acid (ketoanalogue of phenylalanine) calcium salt 68 mg; 3-methyl-2-oxobutyric acid (ketoanalogue of valine) calcium salt 86 mg; (RS)-2-hydroxy-4-methylthio-butyric acid (hydroxyanalogue of DL-methionine) calcium salt 59 mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eEssential Amino Acid Content (per tablet)\u003c\/th\u003e\n\u003ctd\u003eL-lysine acetate 105 mg; L-threonine 53 mg; L-tryptophan 23 mg; L-histidine 38 mg; L-tyrosine 30 mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eTotal Nitrogen per Tablet\u003c\/th\u003e\n\u003ctd\u003e36 mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eCalcium Content per Tablet\u003c\/th\u003e\n\u003ctd\u003e1.25 mmol (50 mg elemental calcium)\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eTypical Adult Dose\u003c\/th\u003e\n\u003ctd\u003e1 tablet per 5 kg body weight per day in divided doses with meals (per Ketosteril Summary of Product Characteristics)\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eStorage\u003c\/th\u003e\n\u003ctd\u003eStore below 25 degrees Celsius in original container\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003cth style=\"background: #f0f4f8; text-align: left;\"\u003eRegulatory\u003c\/th\u003e\n\u003ctd\u003eSingapore HSA registered prescription medicine; manufacturer ISO 9001 and ISO 13485 certified; marketed globally under EMA-aligned SmPC\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003ch2\u003eClinical Indications\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eAdults with stage 4-5 chronic kidney disease (glomerular filtration rate below 25 ml\/min per 1.73 sq m) on a very-low-protein diet (0.3-0.4 g\/kg\/day), to prevent protein-energy wasting\u003c\/li\u003e\n\u003cli\u003eReduction of uraemic symptoms (pruritus, nausea, fatigue) attributable to accumulation of nitrogenous waste products\u003c\/li\u003e\n\u003cli\u003eDelay of dialysis initiation in non-diabetic and selected diabetic CKD patients managed conservatively, per KDIGO 2024 guidance\u003c\/li\u003e\n\u003cli\u003eAttenuation of secondary hyperparathyroidism and metabolic acidosis where dietary protein restriction is the primary nutritional intervention\u003c\/li\u003e\n\u003cli\u003eNutritional management of hyperphosphataemia, as VLPD naturally reduces phosphate intake\u003c\/li\u003e\n\u003cli\u003ePost-transplant patients with residual graft dysfunction and proteinuria, under nephrologist-dietitian co-management\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eWhat is the recommended dose and administration?\u003c\/h3\u003e\n\u003cp\u003eThe Ketosteril SmPC recommends one tablet per 5 kg body weight per day (for a 70 kg adult, approximately 14 tablets daily in three divided doses with meals). Tablets should be swallowed whole with liquid during or immediately after meals to optimise absorption and coadminister with dietary protein. Dose must be individualised by the prescribing nephrologist based on body weight, GFR, and protein intake.\u003c\/p\u003e\n\u003ch3\u003eWhich patients are not candidates for Ketosteril plus VLPD?\u003c\/h3\u003e\n\u003cp\u003eKetosteril is contraindicated in hypercalcaemia, disturbed amino-acid metabolism, and hereditary phenylketonuria (due to phenylalanine ketoanalogue). Caution is required in patients on dialysis (where protein requirements increase to 1.2 g\/kg\/day per KDOQI), in those unable to tolerate VLPD due to sarcopenia risk, and in paediatric populations where evidence is limited. The Subjective Global Assessment and serum albumin should be monitored regularly.\u003c\/p\u003e\n\u003ch3\u003eHow does Ketosteril differ from standard protein-restricted diet alone?\u003c\/h3\u003e\n\u003cp\u003eA VLPD without supplementation risks essential amino acid deficiency, sarcopenia and protein-energy wasting. Ketosteril provides the essential amino acids plus keto-analogues that use endogenous urea-derived nitrogen to regenerate non-essential amino acids. This nitrogen-sparing effect is the clinical rationale: the Cochrane Review and European Renal Nutrition Working Group position papers conclude that VLPD plus keto-analogue supplementation is superior to VLPD alone for metabolic endpoints and dialysis-delay outcomes.\u003c\/p\u003e\n\u003ch3\u003eHow should calcium load be managed?\u003c\/h3\u003e\n\u003cp\u003eEach Ketosteril tablet contributes 50 mg elemental calcium (1.25 mmol). At a therapeutic dose of 14 tablets per day this equates to approximately 700 mg calcium, which must be integrated into the patient's total daily calcium balance, particularly in those already on calcium-based phosphate binders. Serum calcium and corrected calcium should be monitored monthly, and the prescribing team should consider switching to non-calcium binders (sevelamer, lanthanum) in hypercalcaemic patients.\u003c\/p\u003e\n\u003ch3\u003eWhat regulatory status does Ketosteril have in Singapore?\u003c\/h3\u003e\n\u003cp\u003eKetosteril is a prescription-only medicine registered with Singapore Health Sciences Authority (HSA). It must be prescribed by a registered medical practitioner, typically a nephrologist, and dispensed by a licensed pharmacy. Fresenius Kabi manufacturing facilities are certified to ISO 9001 and ISO 13485, and the product is supplied under the Singapore marketing authorisation holder's HSA licence. Essential Medical International Supplies Pte Ltd is a Singapore-licensed medical product dealer.\u003c\/p\u003e\n\n\u003cscript type=\"application\/ld+json\"\u003e\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"FAQPage\",\n  \"mainEntity\": [\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What are the benefits of Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic ?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic  by Fresenius Kabi provides essential amino acids that support muscle repair, recovery, and overall protein synthesis. As with all supplements, individual results may vary. Consult your doctor or pharmacist before starting any new supplement, especially if you have existing medical conditions or are taking medications.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Who should take Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic ?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic  may be suitable for adults looking to support their health and address specific nutritional needs. It may be particularly beneficial for individuals with dietary gaps, those recovering from illness or surgery, or those with increased nutritional demands. Always consult a healthcare professional — your GP, pharmacist, or dietitian — before starting supplementation, especially during pregnancy, breastfeeding, or if you have a chronic condition.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"What is the recommended dosage for Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic ?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Follow the dosage instructions on the Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic  product label or as directed by your healthcare provider. Do not exceed the recommended daily intake. If you experience any adverse reactions, discontinue use and consult a doctor. EMIS+ recommends consulting a Singapore-registered pharmacist or GP for personalised supplement advice.\"\n      }\n    },\n    {\n      \"@type\": \"Question\",\n      \"name\": \"Where can I buy Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic  in Singapore?\",\n      \"acceptedAnswer\": {\n        \"@type\": \"Answer\",\n        \"text\": \"Fresenius Kabi Ketosteril 100 Tablets – Essential Amino Acid \u0026 Keto Analogue Supplement for Chronic  is available from EMIS+ at emis.asia with fast island-wide Singapore delivery. We stock a wide range of quality health supplements from trusted brands. Visit emis.asia or contact our team for product advice and bulk ordering.\"\n      }\n    }\n  ]\n}\n\u003c\/script\u003e","brand":"Fresenius Kabi","offers":[{"title":"Default Title","offer_id":43202816704590,"sku":null,"price":133.0,"currency_code":"SGD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0613\/3763\/2846\/files\/Fresenius_Kabi_Ketosteril.png?v=1767045835","url":"https:\/\/www.emis.asia\/products\/ketosteril-tablets-100s","provider":"EMIS +","version":"1.0","type":"link"}