Kidney Week

Abstract: FR-OR125

Multicenter Randomized Controlled Study of the Efficacy of Low-Protein Rice for Dietary Protein Restriction in Patients with CKD

Session Information

• Translational Advances in Nutrition and Metabolism
  October 26, 2018 | Location: 7B, San Diego Convention Center
  Abstract Time: 05:06 PM - 05:18 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Hosojima, Michihiro, Niigata University, Niigata, Japan

Michihiro Hosojima, MD, PhD

• Kabasawa, Hideyuki, Niigata University, Niigata, Japan

Hideyuki Kabasawa,

• Kaseda, Ryohei, Niigata University, Niigata, Japan

Ryohei Kaseda,

• Ishikawa, Tomomi, Niigata University, Niigata, Japan

Tomomi Ishikawa,

• Obi, Yoshitsugu, University of California, Irvine, California, United States

Yoshitsugu Obi,

• Murayama, Toshiko, Niigata University, Niigata, Japan

Toshiko Murayama,

• Kuwahara, Shoji, Niigata University, Niigata, Japan

Shoji Kuwahara,

• Suzuki, Yoshiki, Niigata University, Niigata, Japan

Yoshiki Suzuki,

• Narita, Ichiei, Niigata University, Niigata, Japan

Ichiei Narita,

• Saito, Akihiko, Niigata University, Niigata, Japan

Akihiko Saito,

Background

The benefits of dietary protein restriction in chronic kidney disease (CKD) remain unclear, largely due to poor adherence to low-protein diet in most clinical studies. Rice, a major staple food globally, is a primary source of dietary plant proteins, especially in Asia. We examined the efficacy of low-protein rice (LPR) for dietary protein restriction in CKD patients.

Methods

This open multicenter randomized controlled study aimed to compare the efficacy of dietary protein restriction [0.7 g/kg ideal body weight (IBW)/day] between CKD patients without LPR (no LPR group) and those with LPR (LPR group) to be eaten in at least 2 meals per day for 24 weeks (UMIN000015630). We enrolled 104 patients (age, 62.7 ± 10.8 years) with CKD (stages G3aA2 and G4) from Niigata University Medical & Dental Hospital and 7 affiliated hospitals from August 2014 to December 2017. Patients in both groups were given regular instruction by dietitians to meet the nutritional goal. Maroni's formula was used to estimate protein intake.

Results

Analysis of covariance was performed adjusted by protein intake at the start of the study. After 24 weeks, estimated protein intake decreased from 0.99±0.23 to 0.80±0.20 g/kg IBW/day in the LPR group and from 0.99±0.23 to 0.91±0.21 g/kg IBW/day in the no LPR group, respectively. The change was significantly higher in the LPR group than in the no LPR group by 0.11 (95% CI, 0.03 to 0.19) g/kg IBW/day (P = 0.001). Energy intake did not differ significantly between the groups; salt intake decreased significantly at 24 weeks in the LPR group. Creatinine clearance did not differ significantly between the groups, but urinary protein excretion decreased significantly at 24 weeks in the LPR group. Also, nutritional indices including diagnostic markers of protein-energy wasting and quality of life showed no significant difference between the groups.

Conclusion

LPR has potential as a feasible tool for dietary protein restriction in CKD patients. Long-term studies are needed to investigate LRP diet and suppression of CKD progression.

Funding

• Commercial Support – Kameda Seika Co.,Ltd., Sato Foods Industries Co.,Ltd., Biotech Japan Co.,Ltd., Forica Foods Co.,Ltd.