Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide Cohort Study.
Study Goal
The researchers aimed to assess the long-term safety and outcomes of a ketoanalogue-supplemented low-protein diet (sLPD) in patients with end-stage renal disease after commencing dialysis.
Results Summary
The sLPD group showed a lower risk of all-cause mortality, major cardiac and cerebrovascular events (MACCEs), and infection-related death compared to the non-sLPD group. The study concluded that sLPD treatment might be safe without long-term negative consequences after dialysis.
Population
Patients with new-onset end-stage renal disease on permanent dialysis in Taiwan (2001-2013).
Effective Dosage
Not specified
Duration
More than 3 months of sLPD treatment in the year preceding dialysis.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
ketoanalogue-supplemented low-protein diet (sLPD) | decrease | dialysis | patients | - | postponing dialysis | #1 |
ketoanalogue-supplemented low-protein diet (sLPD) | decrease | all-cause mortality | patients with new-onset end-stage renal disease with permanent dialysis | 23.1% vs. 27.6%, hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.70⁻0.84 | showed a lower risk of | #2 |
ketoanalogue-supplemented low-protein diet (sLPD) | decrease | major cardiac and cerebrovascular events (MACCEs) | patients with new-onset end-stage renal disease with permanent dialysis | 19.2% vs. 21.5%, HR 0.86, 95% CI 0.78⁻0.94 | showed a lower risk of | #3 |
ketoanalogue-supplemented low-protein diet (sLPD) | decrease | infection-related death | patients with new-onset end-stage renal disease with permanent dialysis | 9.9% vs. 12.5%, HR 0.76, 95% CI 0.67⁻0.87 | showed a lower risk of | #4 |
ketoanalogue-supplemented low-protein diet (sLPD) | no change | long-term outcomes | patients after dialysis treatment | - | might be safe without long-term negative consequences | #5 |
BACKGROUND: A beneficial effect of a ketoanalogue-supplemented low-protein diet (sLPD) in postponing dialysis has been demonstrated in numerous previous studies. However, evidence regarding its effect on long-term survival is limited. Our study assessed the long-term outcomes of patients on an sLPD after commencing dialysis. METHODS: This retrospective study examined patients with new-onset end-stage renal disease with permanent dialysis between 2001 and 2013, extracted from Taiwan's National Health Insurance Research Database. Patients who received more than 3 months of sLPD treatment in the year preceding the start of dialysis were extracted. The outcomes studied were all-cause mortality, infection rate, and major cardiac and cerebrovascular events (MACCEs). RESULTS: After propensity score matching, the sLPD group (n = 2607) showed a lower risk of all-cause mortality (23.1% vs. 27.6%, hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.70⁻0.84), MACCEs (19.2% vs. 21.5%, HR 0.86, 95% CI 0.78⁻0.94), and infection-related death (9.9% vs. 12.5%, HR 0.76, 95% CI 0.67⁻0.87) than the non-sLPD group did. CONCLUSION: We found that sLPD treatment might be safe without long-term negative consequences after dialysis treatment.