Tags

Type your tag names separated by a space and hit enter

Vegetarian low-protein diets supplemented with keto analogues: a niche for the few or an option for many?
Nephrol Dial Transplant. 2013 Sep; 28(9):2295-305.ND

Abstract

BACKGROUND

Low-protein diets are often mentioned but seldom used to slow chronic kidney disease (CKD) progression. The aim of the study was to investigate the potential for implementation of a simplified low-protein diet supplemented with alpha-keto analogues (LPD-KA) as part of the routine work-up in CKD patients.

METHODS

In an implementation study (December 2007-November 2011), all patients with CKD Stages IV-V not on dialysis, rapidly progressive Stage III and/or refractory proteinuria, were offered either a simplified LPD-KA, or commercially available low-protein food. LPD-KA consisted of proteins 0.6 g/kg/day, supplementation with Ketosteril 1 pill/10 Kg, 1-3 free-choice meals/week and a simplified schema based on 'allowed' and 'forbidden' foods. 'Success' was defined as at least 6 months on LPD-KA. Progression was defined as reduction in glomerular filtration rate (GFR)[(Chronic Kidney Disease Epidemiology Collaboration) formula CKD-EPI] in patients with at least 6 months of follow-up.

RESULTS

Of about 2500 patients referred (8% CKD Stages IV-V), 139 started LPD-KA; median age (70 years) and prevalence of comorbidity (79%) were in line with the dialysis population. Start of dialysis was the main reason for discontinuation (40 cases, unplanned in 7); clinical reasons were recorded in 7, personal preference in 14 and improvement and death in 8 each. The low gross mortality (4% per year) and the progression rate (from -8 to 0 mL/min/year at 6 months) are reassuring concerning safety. None of the baseline conditions, including age, educational level, comorbidity or kidney function, discriminated the patients who followed the diet for at least 6 months.

CONCLUSIONS

Our data suggest a wider offer of LPD-KA to patients with severe and progressive CKD. The promising results in terms of mortality and progression need confirmation with different study designs.

Authors+Show Affiliations

SS Nephrology, Department of Clinical and Biological Sciences, ASOU San Luigi, University of Turin, Orbassano, Turin, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23751187

Citation

Piccoli, Giorgina B., et al. "Vegetarian Low-protein Diets Supplemented With Keto Analogues: a Niche for the Few or an Option for Many?" Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 28, no. 9, 2013, pp. 2295-305.
Piccoli GB, Ferraresi M, Deagostini MC, et al. Vegetarian low-protein diets supplemented with keto analogues: a niche for the few or an option for many? Nephrol Dial Transplant. 2013;28(9):2295-305.
Piccoli, G. B., Ferraresi, M., Deagostini, M. C., Vigotti, F. N., Consiglio, V., Scognamiglio, S., Moro, I., Clari, R., Fassio, F., Biolcati, M., & Porpiglia, F. (2013). Vegetarian low-protein diets supplemented with keto analogues: a niche for the few or an option for many? Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 28(9), 2295-305. https://doi.org/10.1093/ndt/gft092
Piccoli GB, et al. Vegetarian Low-protein Diets Supplemented With Keto Analogues: a Niche for the Few or an Option for Many. Nephrol Dial Transplant. 2013;28(9):2295-305. PubMed PMID: 23751187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vegetarian low-protein diets supplemented with keto analogues: a niche for the few or an option for many? AU - Piccoli,Giorgina B, AU - Ferraresi,Martina, AU - Deagostini,Maria C, AU - Vigotti,Federica Neve, AU - Consiglio,Valentina, AU - Scognamiglio,Stefania, AU - Moro,Irene, AU - Clari,Roberta, AU - Fassio,Federica, AU - Biolcati,Marilisa, AU - Porpiglia,Francesco, Y1 - 2013/06/09/ PY - 2013/6/12/entrez PY - 2013/6/12/pubmed PY - 2014/4/18/medline KW - chronic kidney disease KW - nutrition KW - progression of chronic renal failure KW - vegetarian diet SP - 2295 EP - 305 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 28 IS - 9 N2 - BACKGROUND: Low-protein diets are often mentioned but seldom used to slow chronic kidney disease (CKD) progression. The aim of the study was to investigate the potential for implementation of a simplified low-protein diet supplemented with alpha-keto analogues (LPD-KA) as part of the routine work-up in CKD patients. METHODS: In an implementation study (December 2007-November 2011), all patients with CKD Stages IV-V not on dialysis, rapidly progressive Stage III and/or refractory proteinuria, were offered either a simplified LPD-KA, or commercially available low-protein food. LPD-KA consisted of proteins 0.6 g/kg/day, supplementation with Ketosteril 1 pill/10 Kg, 1-3 free-choice meals/week and a simplified schema based on 'allowed' and 'forbidden' foods. 'Success' was defined as at least 6 months on LPD-KA. Progression was defined as reduction in glomerular filtration rate (GFR)[(Chronic Kidney Disease Epidemiology Collaboration) formula CKD-EPI] in patients with at least 6 months of follow-up. RESULTS: Of about 2500 patients referred (8% CKD Stages IV-V), 139 started LPD-KA; median age (70 years) and prevalence of comorbidity (79%) were in line with the dialysis population. Start of dialysis was the main reason for discontinuation (40 cases, unplanned in 7); clinical reasons were recorded in 7, personal preference in 14 and improvement and death in 8 each. The low gross mortality (4% per year) and the progression rate (from -8 to 0 mL/min/year at 6 months) are reassuring concerning safety. None of the baseline conditions, including age, educational level, comorbidity or kidney function, discriminated the patients who followed the diet for at least 6 months. CONCLUSIONS: Our data suggest a wider offer of LPD-KA to patients with severe and progressive CKD. The promising results in terms of mortality and progression need confirmation with different study designs. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/23751187/Vegetarian_low_protein_diets_supplemented_with_keto_analogues:_a_niche_for_the_few_or_an_option_for_many L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gft092 DB - PRIME DP - Unbound Medicine ER -