title: Effect of low-protein diet supplemented with keto acids on progression of chronic kidney disease.
abstract: Hypoproteic diets are most often discussed for patients with chronic kidney disease (CKD) who do not receive dialysis. A very low-protein diet supplemented with ketoanalogues of essential amino acids (keto-diet) proved effective in ameliorating metabolic disturbances of advanced CKD and delaying the initiation of dialysis without deleterious effects on nutritional status. Several recent studies report that the keto-diet could also slow down the rate of decline in renal function, with better outcomes after the initiation of dialysis. Results of a single-center randomized controlled trial addressing the rate of CKD progression revealed a 57% slower decline in renal function with the keto-diet compared with a conventional low-protein diet (LPD). The keto-diet allowed the safe management of selected patients with stage 4-5 CKD, delaying dialysis for almost 1 year, with a major impact on patient quality of life and health expenditures. Therefore, the keto-diet could be a link in the integrated care model. Careful selection of patients, nutritional monitoring, and dietary counseling are required.
authors.affiliation: Department of Nephrology, Carol Davila University of Medicine and Pharmacy, Dr Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania. lilianagarna@yahoo.com
authors.forename: Liliana
authors.initials: L
authors.lastname: Garneata
authors.forename: Gabriel
authors.initials: G
authors.lastname: Mircescu
mesh_terms: D000601:Amino Acids, Essential / Q000008:administration & dosage; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D018450:Disease Progression; D006801:Humans; D007651:Keto Acids / Q000008:administration & dosage*; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy* / Q000503:physiopathology
chemical_list: D000601:Amino Acids, Essential; D004044:Dietary Proteins; D007651:Keto Acids