Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients.
Study Goal
The researchers aimed to evaluate whether a ketoanalogue supplemental low-protein diet (sLPD) could reduce the risks of dialysis among CKD stage 4 patients.
Results Summary
The study found that patients continuing ketosteril treatment for more than three months had a significantly lower incidence of end-stage kidney disease requiring dialysis (6.8% vs. 10.4%) compared to the discontinuation group, without increasing cardiovascular events, infections, or mortality.
Population
Patients aged >20 years with stage 4 chronic kidney disease (CKD).
Effective Dosage
0.6 g/kg body weight per day.
Duration
Follow-up period of one year.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
ketoanalogue supplemental low-protein diet (sLPD) (0.6 g/kg body weight per day) | decrease | short-term risks of commencing dialysis | CKD stage 4 patients | - | may additionally reduce | #1 |
ketosteril treatment | decrease | new-onset end-stage kidney disease (ESKD) requiring maintenance dialysis | Patients aged >20 years with a diagnosis of stage 4 CKD | 6.8% vs. 10.4%, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41−0.94 | exhibited a significantly lower incidence | #2 |
ketoanalogue supplemental low-protein diet (sLPD) | no change | CV events | CKD stage 4 patients | - | without increasing | #3 |
ketoanalogue supplemental low-protein diet (sLPD) | no change | infections | CKD stage 4 patients | - | without increasing | #4 |
ketoanalogue supplemental low-protein diet (sLPD) | no change | mortality | CKD stage 4 patients | - | without increasing | #5 |
Background: Rigid dietary controls and pill burden make a very-low protein (0.3−0.4 g/kg body weight per day), vegetarian diet supplemented with ketoanalogues of amino acids (sVLPD) hard to follow in the long-term. This study aimed to evaluate whether a ketoanalogue supplemental low-protein diet (sLPD) (0.6 g/kg body weight per day) could also reduce the risks of dialysis among CKD stage 4 patients. Methods: Patients aged >20 years with a diagnosis of stage 4 CKD who subsequently received ketosteril treatment, which is the most commonly used ketoanalogue of essential amino acids, between 2003 and 2018 were identified from the Chang Gung Research Database (CGRD). Then, these individuals were divided into two groups according to the continuation of ketosteril for more than three months or not. The primary outcome was ESKD requiring maintenance dialysis. Results: With one-year follow-up, the continuation group (n = 303) exhibited a significantly lower incidence of new-onset end-stage kidney disease (ESKD) requiring maintenance dialysis (6.8% vs. 10.4%, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41−0.94) in comparison to the discontinuation group (n = 238). Conclusions: This study demonstrated that initiating sLPDs since CKD stage 4 may additionally reduce the short-term risks of commencing dialysis without increasing CV events, infections, or mortality.