Clinical Applications of Alpha-Ketoglutarate

Established Clinical Applications

When parenteral nutrition is indicated in acute pancreatitis, parenteral glutamine supplementation (which includes AKG as a precursor) at >0.30 g/kg Ala-Gln dipeptide should be considered, as it decreases infectious complications and mortality in severe acute pancreatitis patients, according to the Clinical Nutrition guidelines 1
Meta-analyses demonstrate that glutamine-enriched nutrition (for which AKG serves as a precursor) significantly decreases infectious complications and mortality in severe acute pancreatitis patients, with beneficial effects including elevation of serum albumin, decreased C-reactive protein, reduced infectious complications, decreased mortality, and shortened hospital stays 1

There are insufficient consistent clinical data to recommend glutamine (and by extension AKG as its precursor) during conventional cytotoxic or targeted therapy, as stated by Clinical Nutrition 2, 3
In hematopoietic stem cell transplantation, glutamine supplementation is not recommended, as one RCT showed more severe oral mucositis and more relapses in the glutamine group, according to Clinical Nutrition 3, 4
The American Academy of Pediatrics recommends L-glutamine (Endari) to reduce the number of pain events in children 5 years and older with sickle cell disease, though the mechanism is poorly understood and may involve regulation of oxidative stress 7