Tags

Type your tag names separated by a space and hit enter

Very low protein diet reduces indoxyl sulfate levels in chronic kidney disease.
Blood Purif. 2013; 35(1-3):196-201.BP

Abstract

BACKGROUND AND OBJECTIVES

High levels of indoxyl sulfate (IS) are associated with chronic kidney disease (CKD) progression and increased mortality in CKD patients. The aim of this pilot study was to assess whether a very low protein diet (VLPD; 0.3 g/kg bw/day), with a consequent low phosphorus intake, would reduce IS serum levels compared to a low protein diet (LPD; 0.6 g/kg bw/day) in CKD patients not yet on dialysis.

MATERIAL AND METHODS

This is a post hoc analysis of a preceding cross-over study aimed to analyze FGF23 during VLPD. Here we performed a prospective randomized controlled crossover study in which 32 patients were randomized to receive either a VLPD (0.3 g/kg bw/day) supplemented with ketoanalogues during the first week and an LPD during the second week (group A, n = 16), or an LPD during the first week and a VLPD during the second week (group B, n = 16 patients). IS serum levels were measured at baseline and at the end of each study period. We compared them to 24 hemodialysis patients (HD) and 14 healthy subjects (control).

RESULTS

IS serum concentration was significantly higher in the HD (43.4 ± 12.3 µM) and CKD (11.1 ± 6.6 µM) groups compared to the control group (2.9 ± 1.1 µM; p < 0.001). IS levels also correlated with creatinine values in CKD patients (R(2) = 0.42; p < 0.0001). After only 1 week of a VLPD, even preceded by an LPD, CKD patients showed a significant reduction of IS serum levels (37%).

CONCLUSIONS

VLPD supplemented with ketoanalogues reduced IS serum levels in CKD patients not yet on dialysis.

Links

Publisher Full Text

Authors+Show Affiliations

Marzocco S
Department of Pharmacy, University of Salerno, Salerno, Italy.
Dal Piaz F
No affiliation info available
Di Micco L
No affiliation info available
Torraca S
No affiliation info available
Sirico ML
No affiliation info available
Tartaglia D
No affiliation info available
Autore G
No affiliation info available
Di Iorio B
No affiliation info available

MeSH

AgedAmino AcidsCase-Control StudiesCreatinineCross-Over StudiesDiet, Protein-RestrictedDisease ProgressionFemaleHumansIndicanKeto AcidsMaleMiddle AgedPilot ProjectsProspective StudiesRenal DialysisRenal Insufficiency, ChronicTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23485887

Clinical Trial Links

Renal Effects of Meditarranean Diet and Low-protein Diet With Ketoacids on Physiological Intestinal Mibrobiota in CKD

Citation

Marzocco, Stefania, et al. "Very Low Protein Diet Reduces Indoxyl Sulfate Levels in Chronic Kidney Disease." Blood Purification, vol. 35, no. 1-3, 2013, pp. 196-201.
Marzocco S, Dal Piaz F, Di Micco L, et al. Very low protein diet reduces indoxyl sulfate levels in chronic kidney disease. Blood Purif. 2013;35(1-3):196-201.
Marzocco, S., Dal Piaz, F., Di Micco, L., Torraca, S., Sirico, M. L., Tartaglia, D., Autore, G., & Di Iorio, B. (2013). Very low protein diet reduces indoxyl sulfate levels in chronic kidney disease. Blood Purification, 35(1-3), 196-201. https://doi.org/10.1159/000346628
Marzocco S, et al. Very Low Protein Diet Reduces Indoxyl Sulfate Levels in Chronic Kidney Disease. Blood Purif. 2013;35(1-3):196-201. PubMed PMID: 23485887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Very low protein diet reduces indoxyl sulfate levels in chronic kidney disease. AU - Marzocco,Stefania, AU - Dal Piaz,Fabrizio, AU - Di Micco,Lucia, AU - Torraca,Serena, AU - Sirico,Maria Luisa, AU - Tartaglia,Domenico, AU - Autore,Giuseppina, AU - Di Iorio,Biagio, Y1 - 2013/03/13/ PY - 2012/08/28/received PY - 2012/12/11/accepted PY - 2013/3/15/entrez PY - 2013/3/15/pubmed PY - 2013/12/16/medline SP - 196 EP - 201 JF - Blood purification JO - Blood Purif VL - 35 IS - 1-3 N2 - BACKGROUND AND OBJECTIVES: High levels of indoxyl sulfate (IS) are associated with chronic kidney disease (CKD) progression and increased mortality in CKD patients. The aim of this pilot study was to assess whether a very low protein diet (VLPD; 0.3 g/kg bw/day), with a consequent low phosphorus intake, would reduce IS serum levels compared to a low protein diet (LPD; 0.6 g/kg bw/day) in CKD patients not yet on dialysis. MATERIAL AND METHODS: This is a post hoc analysis of a preceding cross-over study aimed to analyze FGF23 during VLPD. Here we performed a prospective randomized controlled crossover study in which 32 patients were randomized to receive either a VLPD (0.3 g/kg bw/day) supplemented with ketoanalogues during the first week and an LPD during the second week (group A, n = 16), or an LPD during the first week and a VLPD during the second week (group B, n = 16 patients). IS serum levels were measured at baseline and at the end of each study period. We compared them to 24 hemodialysis patients (HD) and 14 healthy subjects (control). RESULTS: IS serum concentration was significantly higher in the HD (43.4 ± 12.3 µM) and CKD (11.1 ± 6.6 µM) groups compared to the control group (2.9 ± 1.1 µM; p < 0.001). IS levels also correlated with creatinine values in CKD patients (R(2) = 0.42; p < 0.0001). After only 1 week of a VLPD, even preceded by an LPD, CKD patients showed a significant reduction of IS serum levels (37%). CONCLUSIONS: VLPD supplemented with ketoanalogues reduced IS serum levels in CKD patients not yet on dialysis. SN - 1421-9735 UR - https://www.unboundmedicine.com/medline/citation/23485887/Very_low_protein_diet_reduces_indoxyl_sulfate_levels_in_chronic_kidney_disease_ L2 - https://www.karger.com?DOI=10.1159/000346628 DB - PRIME DP - Unbound Medicine ER -