Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet.
OBJECTIVE
A low-protein diet (LPD) is a conservative treatment in patients with chronic kidney disease (CKD) to improve uremic symptoms and slow the progression of renal dysfunction. However, the deleterious effects of protein restriction on nutritional status have raised concern. We investigated whether ketoanalogs supplementation in CKD patients who had training on LPD retards the progression of CKD and maintains nutritional status.


METHODS
Data were collected retrospectively from 120 consecutive patients in the CKD stages III and IV. Firstly all patients were restricted to LPD alone for 6 months (LPD alone), and then ketoanalogs of essential amino acids (KA) were supplemented for 6 months.


RESULTS
The adequate LPD had not achieved in both periods. The declining slopes of glomerular filtration rate (GFR) during the LPD + KA period were significantly lower than those during the LPD alone period. This improvement in GFR was apparent in both subjects with diabetics and non-diabetic patients. Mean serum total cholesterol levels decreased in LPD + KA compared with LPD alone period. However, serum albumin levels did not change. Responders showed a higher prevalence of diabetes and higher serum albumin levels during the LPD alone period. Multivariate analysis revealed that responsiveness to LPD + KA was independently related to diabetes (p = 0.006) and high serum albumin levels (p = 0.011) in the LPD alone period.


CONCLUSIONS
KA supplementation on over LPD delayed the progression of CKD without deteriorating nutritional status, and initial serum albumin levels could be an independent factor.
Chang
Jae Hyun
JH
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Kim
Dong Ki
DK
Park
Jung Tak
JT
Kang
Ea Wha
EW
Yoo
Tae Hyun
TH
Kim
Beom Seok
BS
Choi
Kyu Hun
KH
Lee
Ho Yung
HY
Han
Dae-Suk
DS
Shin
Sug Kyun
SK
D000328:Adult; D000368:Aged; D000601:Amino Acids, Essential / Q000008:administration & dosage*; D002908:Chronic Disease; D018753:Diet, Protein-Restricted; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged
D000601:Amino Acids, Essential; C048995:ketosteril