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Abstract: FR-PO238

Ketosteril Effects on Advanced CKD: Implications from Taiwan Population-Based Study

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • Pei-Chun, Fan, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Taoyuan, Taiwan

Chronic kidney disease (CKD) is a risk factor for mortality and morbidity. Many clinical studies to investigate whether lowering protein intake with ketoacid analogue (LPD-KA) supplement can attenuate the progression of CKD which were unable to have a definite conclusion. This study aims to evaluate the benefit of LPD-KA in patients with advanced CKD.


The study analyzed encrypted datasets from Taiwan’s National Health Insurance Research Database. The exposure group was the LPD-KA which fulfilled the medication possession rate > 90% during the first 90 days of follow up and the comparison group was non-users. Outcomes included mortality, dialysis, cardiovascular event, sepsis and blood transfusion at 2-year follow up. Diabetes mellitus (DM) was a stratum variable of interest.


The data of 2654 patients in the LPD-KA group and 5308 propensity score matched patients in the LPD-KA naive group between January 1, 2001 and December 31, 2013 were analyzed. Patients on LPD-KA had lower mortality (8.1% vs. 11.5%; hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.59-0.81) and lower composite cardiovascular events (10.1% vs. 12.5%; HR 0.78, 95% CI 0.68-0.90). When stratifying analyses by DM, LPA-KA had beneficial effects on composite cardiovascular events and dialysis in patients without DM, but not in patients with DM (P for interaction < 0.05). The LPD-KA prolonged the dialysis for a median of 1.8 months (P < 0.001) in the non-DM group, but not in the DM group (0.2 month, P = 0.515).


LPD-KA might be a effective therapy for patient of CKD especially in patients without DM. Cardiovascular and infective event is less in LPD-KA group. Further investigation with earlier treatment to improve the outcome is warranted.