CHRONIC kidney disease (CKD) patients receive a number of benefits from a very low-protein diet supplemented with ketoanalogues, according to research from the European Renal Nutrition working group of the ERA-EDTA. The team found that such a diet lowers blood pressure, serum phosphate, and albuminuria, in addition to potentially delaying the need for dialysis by 1 year in these patients.
Benefits of Diet
The diet was shown to have a plethora of benefits for certain CKD patients, starting from those with moderate CKD. These were: a lower phosphate burden and reduced serum phosphate levels; reduced proteinuria caused by lower dietary protein intake; in advanced CKD patients with uncontrolled hypertension, a marked and sustained decrease in blood pressure; and in moderate-to-advanced CKD, an improvement in metabolic control and a reduced magnitude of the symptoms of uraemia, enabling dialysis to be delayed for a median period of 1 year, leading to the patient reaching this phase of the disease with reduced cardiovascular complications.
Advice to Patients
The study could lead to changes in the advice given by doctors to CKD patients. “We have to start the nutritional treatment early in CKD and implement a low-protein diet, or even better, a very low-protein diet supplemented with ketoanalogues, in CKD patients right from the beginning, which means in patients whose glomerular filtration rate has dropped below 60 mL/min/1.73m2,” explained Prof Denis Fouque, President, European Renal Nutrition working group. “The very low-protein diet is basically a vegetarian diet supplemented with ketoanalogues, which have the capacity to lower blood urea concentration.”
Not All CKD Patients
The authors emphasise that the diet, while safe, is not suitable for all CKD patients, and recommend its use only in well-nourished, low-comorbidity patients. For patients who are malnourished, and often afflicted with the ‘protein-energy wasting syndrome’, the diet is contraindicated.
A very low-protein diet is defined as 0.3–0.4 g of protein per kg of bodyweight.
James Coker, Reporter
For the source and further information about the study, click here.