Long-term outcome on renal replacement therapy in patients who previously received a keto acid-supplemented very-low-protein diet.
BACKGROUND
The consequences of a supplemented very-low-protein diet remain a matter of debate with regard to patient outcome before or after the onset of renal replacement therapy.


OBJECTIVE
We evaluated the long-term clinical outcome during maintenance dialysis and/or transplantation in patients who previously received a supplemented very-low-protein diet.


METHODS
We assessed the outcome of 203 patients who received a supplemented very-low-protein diet for >3 mo (inclusion period: 1985-2000) and started dialysis after a mean diet duration of 33.1 mo (4-230 mo).


RESULTS
The survival rate in the whole cohort was 79% and 63% at 5 and 10 y, respectively. One hundred two patients continued with chronic dialysis during the entire follow-up, and 101 patients were grafted at least once. Patient outcomes were similar to those of the French Dialysis Registry patients for the dialysis group and similar to the 865 patients who were transplanted in Bordeaux during the same period for the transplant group. There was no correlation between death rate and duration of diet.


CONCLUSIONS
The lack of correlation between death rate and duration of diet and the moderate mortality rate observed during the first 10 y of renal replacement therapy confirm that a supplemented very-low-protein diet has no detrimental effect on the outcome of patients with chronic kidney disease who receive renal replacement therapy.
Chauveau
Philippe
P
Department of Nephrology, Centre Hospitalier Universitaire and University Bordeaux II, Bordeaux, France. ph.chauveau@wanadoo.fr
Couzi
Lionel
L
Vendrely
Benoit
B
de Précigout
Valérie
V
Combe
Christian
C
Fouque
Denis
D
Aparicio
Michel
M
D000328:Adult; D000368:Aged; D018753:Diet, Protein-Restricted / Q000009:adverse effects*; D019587:Dietary Supplements; D006801:Humans; D007651:Keto Acids / Q000008:administration & dosage / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000401:mortality / Q000628:therapy; D016030:Kidney Transplantation / Q000401:mortality*; D008875:Middle Aged; D006435:Renal Dialysis / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D007651:Keto Acids