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Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients.
Eur J Clin Nutr. 2005 Jan; 59(1):129-36.EJ

Abstract

OBJECTIVE

To evaluate the effects on the nutritional and metabolic parameters of a very-low-protein diet supplemented with ketoacids (VLPD+KA) in comparison with a conventional low-protein diet (LPD) in chronic kidney disease (CKD) patients.

DESIGN

Prospective, randomized, controlled clinical study.

SETTING

Outpatient Clinic of the Nephrology Division of Federal University of Sao Paulo, Brazil.

SUBJECTS

The study involved 24 patients with advanced CKD (creatinine clearance <25 ml/min) that were randomly assigned to either a VLPD+KA (VLPD+KA group, 12 patients) or to a conventional LPD with 0.6 g/kg/day (LPD group, 12 patients). The patients were followed for 4 months.

RESULTS

Nutritional status was adequately maintained with both diets for the studied period. Protein intake and serum urea nitrogen decreased significantly only in the VLPD+KA group (from 0.68+/-0.17 to 0.43+/-0.12 g/kg/day, P<0.05; from 61.4+/-12.8 to 43.6+/-14.9 mg/dl, P<0.001; respectively). Ionized calcium did not change in the VLPD+KA group but tended to decrease in the LPD group. Serum phosphorus tended to decrease in the VLPD+KA group probably as a result of a significant reduction in dietary phosphorus (529+/-109 to 373+/-125 mg/day, P<0.05) associated to the phosphorus-binding effect of the ketoacids. No change in these parameters was found in the LPD group. Serum parathormone increased significantly only in the LPD group (from 241+/-138 to 494+/-390 pg/ml, P<0.01). The change in PTH concentration was negatively correlated with changes in ionized calcium concentration (r=-0.75, P=0.02) and positively correlated with changes in serum phosphorus (r=0.71, P=0.03) only in the LPD group.

CONCLUSION

This study indicates that a VLPD+KA can maintain the nutritional status of the patients similarly to a conventional LPD. Besides, an improvement in calcium and phosphorus metabolism and a reduction in serum urea nitrogen were attained only with the VLPD+KA. Thus, VLPD+KA can constitute another efficient therapeutic alternative in the treatment of CKD patients.

Authors+Show Affiliations

Feiten SF
Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.
Draibe SA
No affiliation info available
Watanabe R
No affiliation info available
Duenhas MR
No affiliation info available
Baxmann AC
No affiliation info available
Nerbass FB
No affiliation info available
Cuppari L
No affiliation info available

MeSH

AdultBlood Urea NitrogenCalciumDiet, Protein-RestrictedFemaleHumansKeto AcidsKidney Failure, ChronicMaleMiddle AgedNutritional StatusPhosphorusProspective StudiesTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15354199

Citation

Feiten, S F., et al. "Short-term Effects of a Very-low-protein Diet Supplemented With Ketoacids in Nondialyzed Chronic Kidney Disease Patients." European Journal of Clinical Nutrition, vol. 59, no. 1, 2005, pp. 129-36.
Feiten SF, Draibe SA, Watanabe R, et al. Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients. Eur J Clin Nutr. 2005;59(1):129-36.
Feiten, S. F., Draibe, S. A., Watanabe, R., Duenhas, M. R., Baxmann, A. C., Nerbass, F. B., & Cuppari, L. (2005). Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients. European Journal of Clinical Nutrition, 59(1), 129-36.
Feiten SF, et al. Short-term Effects of a Very-low-protein Diet Supplemented With Ketoacids in Nondialyzed Chronic Kidney Disease Patients. Eur J Clin Nutr. 2005;59(1):129-36. PubMed PMID: 15354199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients. AU - Feiten,S F, AU - Draibe,S A, AU - Watanabe,R, AU - Duenhas,M R, AU - Baxmann,A C, AU - Nerbass,F B, AU - Cuppari,L, PY - 2004/9/9/pubmed PY - 2005/4/9/medline PY - 2004/9/9/entrez SP - 129 EP - 36 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 59 IS - 1 N2 - OBJECTIVE: To evaluate the effects on the nutritional and metabolic parameters of a very-low-protein diet supplemented with ketoacids (VLPD+KA) in comparison with a conventional low-protein diet (LPD) in chronic kidney disease (CKD) patients. DESIGN: Prospective, randomized, controlled clinical study. SETTING: Outpatient Clinic of the Nephrology Division of Federal University of Sao Paulo, Brazil. SUBJECTS: The study involved 24 patients with advanced CKD (creatinine clearance <25 ml/min) that were randomly assigned to either a VLPD+KA (VLPD+KA group, 12 patients) or to a conventional LPD with 0.6 g/kg/day (LPD group, 12 patients). The patients were followed for 4 months. RESULTS: Nutritional status was adequately maintained with both diets for the studied period. Protein intake and serum urea nitrogen decreased significantly only in the VLPD+KA group (from 0.68+/-0.17 to 0.43+/-0.12 g/kg/day, P<0.05; from 61.4+/-12.8 to 43.6+/-14.9 mg/dl, P<0.001; respectively). Ionized calcium did not change in the VLPD+KA group but tended to decrease in the LPD group. Serum phosphorus tended to decrease in the VLPD+KA group probably as a result of a significant reduction in dietary phosphorus (529+/-109 to 373+/-125 mg/day, P<0.05) associated to the phosphorus-binding effect of the ketoacids. No change in these parameters was found in the LPD group. Serum parathormone increased significantly only in the LPD group (from 241+/-138 to 494+/-390 pg/ml, P<0.01). The change in PTH concentration was negatively correlated with changes in ionized calcium concentration (r=-0.75, P=0.02) and positively correlated with changes in serum phosphorus (r=0.71, P=0.03) only in the LPD group. CONCLUSION: This study indicates that a VLPD+KA can maintain the nutritional status of the patients similarly to a conventional LPD. Besides, an improvement in calcium and phosphorus metabolism and a reduction in serum urea nitrogen were attained only with the VLPD+KA. Thus, VLPD+KA can constitute another efficient therapeutic alternative in the treatment of CKD patients. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/15354199/Short_term_effects_of_a_very_low_protein_diet_supplemented_with_ketoacids_in_nondialyzed_chronic_kidney_disease_patients_ DB - PRIME DP - Unbound Medicine ER -