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Ketoanalogue-Supplemented Very Low-Protein Diet May Benefit CKD

Four patients would need to adhere to diet to avoid primary end point in per-protocol analysis

kidney illustration

FRIDAY, Jan. 29, 2016 (HealthDay News) -- A ketoanalogue-supplemented vegetarian very low-protein diet (KD) seems safe and may be able to slow chronic kidney disease progression, according to a study published online Jan. 28 in the Journal of the American Society of Nephrology.

Liliana Garneata, M.D., Ph.D., from the "Carol Davila" University of Medicine and Pharmacy in Bucharest, Romania, and colleagues conducted a prospective, randomized controlled trial of the safety and efficacy of KD versus conventional low-protein diet (LPD). Adults without diabetes and with stable estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m², proteinuria <1 g/g urinary creatinine, good nutritional status, and good diet compliance entered a run-in LPD phase. Compliant patients were randomized after three months to KD or to continue LPD for 15 months.

The researchers found that to avoid the primary end point of renal replacement therapy initiation or >50 percent reduction in initial eGFR, the adjusted numbers needed to treat (NNT) were 4.4 and 4.0 in intention-to-treat and per-protocol analyses, respectively, for patients with eGFR <30 ml/min/m². To avoid dialysis, the adjusted NNT was 22.4 for patients with eGFR <30 ml/min/1.73 m² and decreased to 2.7 for patients with eGFR of <20 ml/min/1.73 m². With KD only there was correction of metabolic abnormalities. Diet compliance was good and there were no changes in nutritional parameters or adverse reactions.

"This KD seems nutritionally safe and could defer dialysis initiation in some patients with CKD," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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