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[Progression of renal function in patients with chronic kidney disease on a low-protein diet supplemented with aminoacids and ketoanalogues].

Nutricion hospitalaria
April 27, 2018
María Andrea Aimar et al. (8 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to assess the progression of renal failure in adult patients with CKD stages 3b and 4 receiving a low-protein diet supplemented with amino acids and ketoanalogues.

Results Summary

The study found that the low-protein diet supplemented with ketoanalogues preserved nutritional condition and mineral balance, significantly improved glomerular filtration, and decreased urea levels. Body mass index and albumin levels remained stable over the study period.

Population

Adult patients with chronic kidney disease (CKD) stages 3b and 4 (67% male, mean age 59.7 years).

Effective Dosage

0.4-0.6 g/kg/day protein, 30-35 kcal/kg/day, plus 11.87 tablets/day of Ketosteril® (approximately 1 tablet per 5 kg body weight).

Duration

12 months

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
a low-protein diet supplemented with ketoanalogues
no change
nutritional condition
patients with CKD stages 3b and 4
-
preserved
#1
a low-protein diet supplemented with ketoanalogues
no change
mineral balance
patients with CKD stages 3b and 4
-
preserved
#2
a low-protein diet supplemented with ketoanalogues
increase
glomerular filtration (GF)
patients with CKD stages 3b and 4
24.97 ± 6.64 ml/min/1.73 m2 to 29.26 ± 10.33 ml/min/1.73 m2
improved GF significantly
#3
a low-protein diet supplemented with ketoanalogues
decrease
urea levels
patients with CKD stages 3b and 4
-
decreased
#4
a protein-controlled diet supplemented with aminoacids and ketoanalogues
no change
Body mass index
adult patients with CKD stages 3b and 4
26.63 ± 4.08 kg/m2 to 26.78 ± 3.98 kg/m2
did not change significantly
#5
a protein-controlled diet supplemented with aminoacids and ketoanalogues
increase
glomerular filtration (GF)
adult patients with CKD stages 3b and 4
25.51 ± 8.57 to 29.26 ± 10.33 ml/min/1.73 m2
showed a significant increase
#6
a protein-controlled diet supplemented with aminoacids and ketoanalogues
decrease
Urea nitrogen
adult patients with CKD stages 3b and 4
-
decreased significantly
#7
a protein-controlled diet supplemented with aminoacids and ketoanalogues
no change
albumin levels
adult patients with CKD stages 3b and 4
3.53 ± 0.64 g/l to 4.00 ± 0.53 g/l
did not change significantly
#8
Abstract

INTRODUCTION: chronic kidney disease (CKD) is a public health problem. Low-protein diets supplemented with ketoacids and essential aminoacids have proved effective at different CKD stages. AIM: to assess the progression of renal failure in adult patients with CKD stages 3b and 4 receiving a protein-controlled diet supplemented with aminoacids and ketoanalogues. METHODS: retrospective, descriptive intervention study. The nutritional intervention consisted of a protein/calorie intake of 0.4-0.6 g/kg/day and 30-35 kcal/kg/day plus a tablet of ketoanalogues (Ketosteril®)/5 kg weight. We assessed nutritional condition, glomerular filtration (GF) and creatinine, urea and albumin levels at 0, 3, 6, 9 and 12 months. SPSS version 18 was used for data statistical analysis. RESULTS: thirty-three patients were studied (67% male; mean age 59.7 years, r: 24-87). Protein/calorie intake was 0.55 ± 0.20 g/kg/day and 34 ± 4.51 kcal/kg/day. Ketosteril® intake was 11.87 tablets/day (r: 9-14). Initial GF was 24.97 ± 6.64 ml/min/1.73 m2, showing a significant increase between three and 12 months (25.51 ± 8.57 and 29.26 ± 10.33 ml/min/1.73 m2; p = 0.006). Urea nitrogen decreased significantly at six months compared with the initial level (p < 0.005). Body mass index did not change significantly (initial, 26. 63 ± 4.08 kg/m2; after a year, 26.78 ± 3.98 kg/m2). Initial and final albumin levels were 3.53 ± 0.64 g/l and 4.00 ± 0.53 g/l, respectively (p = 0.79). CONCLUSION: a low-protein diet supplemented with ketoanalogues administered to patients with CKD stages 3b and 4 preserved nutritional condition and mineral balance, improved GF significantly and decreased urea levels.

Medical Subject Headings (MeSH)
AdultAgedAged, 80 and overAmino AcidsDiet, Protein-RestrictedDietary SupplementsDisease ProgressionFemaleHumansKetonesKidney Function TestsMaleMiddle AgedNutritional StatusRenal Insufficiency, ChronicRetrospective StudiesYoung Adult
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality70/10
Citation Metrics
Total Citations1
Citations/Year0.1
Relative Citation Ratio0.06
NIH Percentile3%
Research Impact Scores
APT Score0.05
Weight Score1.61
Normalized Score0.68
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