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A Low-Protein Diet with a Renal-Specific Oral Nutrition Supplement Helps Maintain Nutritional Status in Patients with Advanced Chronic Kidney Disease.

Journal of personalized medicine
December 14, 2021
Owen J Kelly et al. (9 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine whether a low-protein diet supplemented with a renal-specific oral nutrition supplement (RONS) could improve nutritional status and delay renal function decline in patients with advanced chronic kidney disease (CKD).

Results Summary

The study found that RONS use increased energy intake, maintained serum albumin and nutritional status, improved quality of life, and slightly preserved residual renal function, though eGFR decreased modestly over time. Body weight and handgrip strength significantly improved after 6 months.

Population

Patients aged 18+ with stage 3b-5 CKD (eGFR 10-45 mL/min/1.73 m²), serum albumin ≥3.0 g/dL, and BMI ≤30 kg/m².

Effective Dosage

One serving of RONS daily.

Duration

6 months.

Interactions

None mentioned.

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
increase
energy intake
patients with stage 3b-5 CKD
-
increased
#1
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
no change
serum albumin
patients with stage 3b-5 CKD
-
maintained
#2
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
no change
nutritional status
patients with stage 3b-5 CKD
-
maintained
#3
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
no change
quality of life
patients with stage 3b-5 CKD
-
maintained
#4
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
increase
body weight
patients with stage 3b-5 CKD
-
increased significantly
#5
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
increase
handgrip strength
patients with stage 3b-5 CKD
-
increased significantly
#6
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
decrease
eGFR
patients with stage 3b-5 CKD
-
slightly decreased
#7
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
no change
residual renal function
patients with stage 3b-5 CKD
-
preserved
#8
low-protein diet (LPD) including a renal-specific oral nutrition supplement (RONS)
decrease
renal function decline
patients with non-dialysis advanced CKD
-
delay
#9
Abstract

A low-protein diet (LPD) is recommended to patients with non-dialysis advanced chronic kidney disease (CKD) for delaying renal function decline. However, this approach potentially prevents an adequate calorie and micronutrient intake. We examined the influence of an LPD including a renal-specific oral nutrition supplement (RONS) on the nutrition status of patients with stage 3b-5 CKD. This multicenter, open-label study prospectively enrolled patients over 18 years of age, with an estimated glomerular filtration rate (eGFR) between 10 and 45 mL/min/1.73 m2, serum albumin ≥3.0 g/dL, and body mass index ≤30 kg/m2. All participants implemented the LPD with one serving of RONS daily for 6 months. Daily energy intake, nutrition status, renal function, and quality of life were assessed before and after the intervention. Of 53 enrolled patients, 35 (66.0%) completed the study. We found that RONS use increased patients' energy intake and maintained their serum albumin, nutritional status, and quality of life. Body weight and handgrip strength increased significantly at 6 months after enrollment (p = 0.0357); eGFR slightly decreased at 3 and 6 months after enrollment, suggesting that patients' residual renal function was preserved. Our findings support the conclusion that patients with non-dialysis advanced CKD may benefit from additional RONS besides their regular diet. Patients with advanced CKD receiving RONS might achieve better nutrition and delay renal function decline.

Study Links
Quality Scores
Safety85
Efficacy80/10
Quality75/10
Citation Metrics
Total Citations8
Citations/Year2.0
Relative Citation Ratio0.93
NIH Percentile47.7%
Research Impact Scores
APT Score0.50
Weight Score1.17
Normalized Score0.81
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