| Summary: | A protein-restricted diet with keto/amino acids (KA) supplement showed favorable effects on delayed renal replacement therapy in patients with chronic kidney disease. This is an open, prospective, randomized, and multi-center study. A total of 67 patients were randomly assigned into two groups. LPD+KA group was advised to take less than 0.6 g/kg/day of protein with KAs. LPD group was advised to consume less than 0.6 g/kg/day protein. Nutritional and clinical parameters were evaluated at baseline, 3 and 6 months. Nutritional status represented as body mass index, mid-arm circumference and triceps skin-fold thickness was not different between the two groups at 3months and 6 months. Ca×P product level measured at 3 months was lower in the LPD+KA group than in the LPD group (LPD+KA group: 33.5±5.0 vs. LPD group: 36.9±7.9 mg2/dL2, p<0.05). The slope of the glomerular filtration rate (GFR slope) and the percentage of the GFR slope (GFR slope %) at 3 months were more preserved in the LPD+KA group than in the LPD group. The GFR slope and GFR slope % at 6 months were not significantly different. In the entire subjects, the GFR slope was negatively correlated with Ca×P product levels at 3 months, total cholesterol at baseline, and urine protein-creatinine ratio at baseline and 6 months (r=−0.255, r=−0.296, r =−0.412, r=−0.371, p<0.05). A multiple regression analysis revealed Ca×P product at 3 months was the only independent factor affecting the GFR slope at 3 months. The present study suggests that a low protein diet supplemented with KA had a beneficial effect on preserving renal function and improving calcium and phosphorus disturbances in patients with chronic kidney disease.
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