Abstract: SA-PO147

Randomized Controlled Clinical Study to Prevent Decline in Renal Function and Nutritional Status in Predialysis Patients Using Ketoanalogue Supplementation

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Saxena, Anita, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
  • Gupta, Amit, Department of Nephrology, Lucknow, India
  • Sachan, Trisha, sanjay gandhi post graduate institute of medical sciences, Lucknow, India
  • Pandey, Chandra M., Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
Background

Low protein diet is a means to protect residual renal function and to slow down progression of CKD to end stage renal disease. Study was conducted to evaluate effect of combined therapy of very low protein diet (vLPD) and ketoanalogues on renal function of predialysis patients and compliance to very low protein diet.

Methods

Prospective randomized controlled study. Forty patients divided into two groups of 20 each. CKD patients with GFR <60 but >30 ml/minute were included. Group I was supplemented with 300 mg/d of ketoanalogues combined with 0.4 gram /kg day protein (vLPD) and 35 kcal/kg/d of energy for 10 months. Group 2, control, was kept on low protein diet 0.6 g/kg /day and 35 kcal/kg /day energy. Biochemical investigations, included serum albumin, hemoglobin, sodium, potassium, calcium, phosphorus, and blood glucose were done at baseline (visit 1) and at 10 months (Visit 2). Dietary intake was taken by dietician. Nutritional status was assessed using SGA.

Results

At baseline, the GFR was higher in controls (51.14±15.1 ml/min). compared to ketoanalogue group (47.79±13.2 ml/min). GFR declined in the control group from 51.14 ml/min at baseline to 35.5±7.94 ml/min over a period of 10 months. In ketoanalogue group the GFR remained stable after 10 months 47.65±13.26.ml/min (47.79±13.2 at baseline). Serum albumin was preserved at 4.03 ±0.52 g/dL after10 months (4.11±0.43 g/dL at visit 1) in ketoanalogue group. In control group serum albumin decreased from 3.8±0.90 g/dL at visit 1 to 3.09±0.38 after 10 months (visit 2). GFR (p = 0.023) and serum albumin (p =0.000) were significantly higher in ketoanalogue vLPD group compared to controls at visit 2. Group 1 patients were noncompliant to vLPD as protein intake was 0.62±0.24 g/kg/d instead of 0.4 g/kg/d but GFR remained stable at 47.7 ml/min over 10 months. Energy intake was low 19.48±6.84 kcal/kg/d and 16.15±5.85 kcal/kg/d in group 1 and 2 respectively compared to RDA.

Conclusion

Ketoanalogue supplementation preserves nutritional status and prevents decline renal function.