Low Protein Diet Reduces Proteinuria and Decline in Glomerular Filtration Rate in Advanced, Heavy Proteinuric Diabetic Kidney Disease.
Study Goal
The researchers aimed to assess the efficacy of a low-protein diet supplemented with ketoanalogues in reducing proteinuria and slowing the decline of kidney function in patients with advanced diabetic kidney disease.
Results Summary
The study found that the low-protein diet supplemented with ketoanalogues reduced proteinuria by 3-fold and slowed the decline in eGFR by 5-fold, effectively postponing the need for kidney replacement therapy without any reported deaths or KRT initiations.
Population
Patients with advanced diabetic kidney disease (stable proteinuria > 3 g/g and eGFR < 30 mL/min) who had good nutritional status and agreed to a low-protein diet.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Low protein diet (LPD) | decrease | complications of chronic kidney disease (CKD) | - | - | seems beneficial in ameliorating | #1 |
Low protein diet (LPD) | decrease | proteinuria | - | - | reducing | #2 |
Low protein diet (LPD) | decrease | decline in kidney function | - | - | reducing | #3 |
Low protein diet (LPD) | decrease | need for kidney replacement therapy (KRT) | - | - | postponing | #4 |
LPD supplemented with ketoanalogues of essential amino acids (KA) | decrease | proteinuria | patients with advanced DKD | 3-fold | decreased | #5 |
LPD supplemented with ketoanalogues of essential amino acids (KA) | decrease | rate of decline in eGFR | patients with advanced DKD | 5-fold | decreased | #6 |
LPD supplemented with ketoanalogues of essential amino acids (KA) | decrease | KRT | patients with advanced DKD | - | seems effective in safely postponing | #7 |
LPD supplemented with ketoanalogues of essential amino acids (KA) | decrease | proteinuria | patients with advanced DKD | - | reducing | #8 |
LPD supplemented with ketoanalogues of essential amino acids (KA) | decrease | decline in kidney function | patients with advanced DKD | - | reducing | #9 |
Low protein diet (LPD) seems beneficial in ameliorating the complications of chronic kidney disease (CKD), in reducing proteinuria and the decline in kidney function, thus postponing the need for kidney replacement therapy (KRT). However, this type of intervention was less investigated in diabetic kidney disease (DKD). This is a single-center, prospective, interventional study that aims to assess the efficacy of reducing proteinuria and the rate of decline in the estimated glomerular filtration rate (eGFR). Patients with advanced DKD (stable proteinuria > 3 g/g and eGFR < 30 mL/min) with a good nutritional status and accepting a LPD were evaluated for inclusion. Ninety-two of the 452 screened patients (66% males, median age 61 years, proteinuria 4.8 g/g creatininuria, eGFR 11.7 mL/min/1.73 m2) completed the study. Intervention consisted of LPD supplemented with ketoanalogues of essential amino acids (KA) along with conventional nephroprotective therapy. Efficacy parameters were the variation in proteinuria and in eGFR from baseline to the end of the study. Proteinuria decreased 3-fold, and the rate of decline in eGFR decreased 5-fold in the intervention phase. No patient initiated KRT or died. LPD supplemented with KA seems effective in safely postponing KRT by reducing proteinuria and the decline in kidney function in advanced DKD.