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Abstract: SA-PO1071

The Effects of Restricted Protein Diet Supplemented with Keto-Analogue on Renal Function, Nutritional Status, and CKD-Mineral and Bone Disorder in CKD Patients: A Meta-Analysis

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Susantitaphong, Paweena, Chulalongkorn University, Bangkok, Thailand
  • Chewcharat, Api, Chulalongkorn University, Bangkok, Thailand
  • Takkavatakarn, Kullaya, Division of Nephrology, King Chulalongkorn Memorial hospital, Bangkok, Thailand
  • Wongrattanagorn, Sasitorn, Chulalongkorn University, Bangkok, Thailand
  • Panrong, Krissana, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Kittiskulnam, Piyawan, Chulalongkorn university, Bangkok, Thailand
  • Eiam-Ong, Somchai, Chulalongkorn University, Bangkok, Thailand
  • Praditpornsilpa, Kearkiat, Chulalongkorn University, Bangkok, Thailand
Background

The prevalence of CKD and its complications are incessantly increasing. The important strategies are how to delay the progression of CKD and postpone renal replacement therapy. Dietary protein restriction(low or very low protein diet) with or without KA supplement might slow down the rate of renal function declination without increasing the risk of malnutrition. We aimed to evaluate the efficacy and side effects of restricted protein diet supplemented with KA on the treatment of CKD.

Methods

A literature search was performed via PubMed, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov from January 1960 to May 2018 to identify randomized controlled trials(RCTs) which explored the effects of restricted protein diet with KA on slowing progression of CKD, nutritional status, and CKD-MBD. Random-effect model was used to compute the weighted mean difference (WMD) for continuous variables.

Results

Seventeen RCTs with 1,475 participants were included in our meta-analysis. Restricted protein diet with KA supplementation significantly improved estimated GFR (WMD = 3.14 mL/min/1.73m2 (0.68, 5.61), P=0.013), reduced proteinuria (WMD = -0.86 g/d (-1.71, -0.02), P = 0.046), serum phosphate (WMD = -0.68 mg/dl (-1.02, -0.33), P < 0.001), parathyroid hormone level (WMD = -73.70 pg/mL(-132.79, -14.61), P = 0.015),
systolic blood pressure (WMD = -4.96 mmHg (-8.03, -1.90), P = 0.002) , diastolic blood
pressure (WMD = -2.39 mmHg (-3.84, -0.95), P = 0.001), and serum cholesterol (WMD = -17.66 mg/dL (-33.19, -2.14, P = 0.03). Of interest, the treatment could raise serum albumin (WMD = 0.12g/dl (0.01, 0.22), P= 0.04) and serum calcium (WMD =0.50 mg/dL (0.21, 0.80), P=0.001).

Conclusion

Restricted protein diet supplemented with KA could effectively improve kidney endpoints, CKD-MBD parameters and blood pressure parameters without causing malnutrition. However, the significant increased serum calcium should be monitored.