Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients
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 (sL...
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MDPI AG
2022-09-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/19/4020 |
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| author | Chieh-Li Yen Pei-Chun Fan Jia-Jin Chen George Kuo Ching-Chung Hsiao Chao-Yu Chen Yi-Ran Tu Hsiang-Hao Hsu Yung-Chang Chen Chih-Hsiang Chang |
| author_facet | Chieh-Li Yen Pei-Chun Fan Jia-Jin Chen George Kuo Ching-Chung Hsiao Chao-Yu Chen Yi-Ran Tu Hsiang-Hao Hsu Yung-Chang Chen Chih-Hsiang Chang |
| author_sort | Chieh-Li Yen |
| collection | DOAJ |
| description | 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 (<i>n</i> = 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 (<i>n</i> = 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. |
| first_indexed | 2024-03-09T21:19:50Z |
| format | Article |
| id | doaj.art-7f11fb2ab30047b1ab2fb076d96d0055 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T21:19:50Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-7f11fb2ab30047b1ab2fb076d96d00552023-11-23T21:24:13ZengMDPI AGNutrients2072-66432022-09-011419402010.3390/nu14194020Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 PatientsChieh-Li Yen0Pei-Chun Fan1Jia-Jin Chen2George Kuo3Ching-Chung Hsiao4Chao-Yu Chen5Yi-Ran Tu6Hsiang-Hao Hsu7Yung-Chang Chen8Chih-Hsiang Chang9Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, TaiwanBackground: 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 (<i>n</i> = 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 (<i>n</i> = 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.https://www.mdpi.com/2072-6643/14/19/4020low protein dietCKDESKDketosterildietary therapy |
| spellingShingle | Chieh-Li Yen Pei-Chun Fan Jia-Jin Chen George Kuo Ching-Chung Hsiao Chao-Yu Chen Yi-Ran Tu Hsiang-Hao Hsu Yung-Chang Chen Chih-Hsiang Chang Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients Nutrients low protein diet CKD ESKD ketosteril dietary therapy |
| title | Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients |
| title_full | Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients |
| title_fullStr | Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients |
| title_full_unstemmed | Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients |
| title_short | Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients |
| title_sort | ketoanalogues supplemental low protein diet safely decreases short term risk of dialysis among ckd stage 4 patients |
| topic | low protein diet CKD ESKD ketosteril dietary therapy |
| url | https://www.mdpi.com/2072-6643/14/19/4020 |
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