title: Effect of restricted protein diet supplemented with keto analogues in chronic kidney disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  To evaluate the efficacy and safety of the restricted protein diet (low or very low protein diet) supplemented with keto analogues in the treatment of chronic kidney disease (CKD).
  
  
  METHODS
  The Cochrane library, PubMed, Embase, CBM and CENTRAL databases were searched and reviewed up to April 2015. Clinical trials were analyzed using RevMan 5.3 software.
  
  
  RESULTS
  Seven random control trials, one cross-over trial and one non-randomized concurrent control trial were selected and included in this study according to our inclusion and exclusion criteria. The changes of eGFR, BUN, Scr, albumin, PTH, triglyceride, cholesterol, calcium, phosphorus and nutrition indexes (BMI, lean body mass and mid-arm muscular circumference) before and after treatment were analyzed. The meta-analysis results indicated that, comparing with normal protein diet, low protein diet (LPD) or very low protein diet (vLPD) supplemented with keto analogues (s(v)LPD) could significantly prevent the deterioration of eGFR (P < 0.001), hyperparathyroidism (P = 0.04), hypertension (P < 0.01) and hyperphosphatemia (P < 0.001). No differences in BUN, Scr, Albumin, triglyceride, cholesterol, hemoglobin, calcium and nutrition indexes were observed between different protein intake groups.
  
  
  CONCLUSIONS
  Restricted protein diet supplemented with keto analogues (s(v)LPD) could delay the progression of CKD effectively without causing malnutrition.
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Lichuan
authors.initials: L
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zi
authors.initials: Z
authors.lastname: Li
authors.affiliation: Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China. ddqstrike@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Qin
mesh_terms: D018753:Diet, Protein-Restricted / Q000379:methods*; D019587:Dietary Supplements; D018450:Disease Progression; D006801:Humans; D007661:Ketoses / Q000494:pharmacology*; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy*
chemical_list: D007661:Ketoses
keywords: Chronic kidney disease; Keto analogues; Meta-analysis; Restricted protein diet; Systematic review