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Kidney Week

Abstract: INFO19

Ketogenic Interventions in ADPKD: A Translational Project Pipeline

Session Information

Category: Genetic Diseases of the Kidneys

  • No subcategory defined

Authors

  • Grundmann, Franziska, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  • Strubl, Sebastian, University of California Santa Barbara, Santa Barbara, CA, US, Santa Barbara, California, United States
  • Oehm, Simon, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  • Steinke, Konstantin, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
  • Korst, Uwe K.H., PKD Familiaere Zystennieren e.V., Bensheim, Germany
  • Weimbs, Thomas, University of California Santa Barbara, Santa Barbara, CA, US, Santa Barbara, California, United States
  • Mueller, Roman-Ulrich, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
Description

Evidence in animal models suggests that ketogenic dietary interventions are promising strategies to ameliorate disease progression in autosomal dominant polycystic kidney disease (ADPKD). It is now timely to aim for translation of this approach to the clinical setting through trials that collect data on feasibility, safety and efficacy in patients. To tackle this challenge the University of Cologne(UoC) and the University of California Santa Barbara(UCSB) have joint forces to develop a pipeline for the design of clinical projects.
Retrospective Case Series Study: As ADPKD patients may already have experimented with ketogenic diets for health benefits, a case series was initiated to collect patient-reported data in interviews about effects and feasibility of ketogenic diets for ADPKD patients. The data suggest that ketogenic diets could be beneficial for the overall well-being of PKD patients. The Case Series was initiated by UCSB and is currently extended to a large cohort managed at UoC.
Questionnaire on eating habits and special diets: In collaboration with the patient organization PKD Germany, members were asked to report specific diets such as low-carb, ketogenic or vegan/vegetarian nutrition in order to analyze interest in dietary interventions within the community and identify potential future study participants.
RESET-ADPKD: This proof-of-principle trial aims to provide first-in-man data on effects of ketogenic interventions. We investigate the effects of short-term ketosis on total kidney volume (TKV) in 10 ADPKD patients. Ketosis is induced either by 3-day water fasting or a 14-day ketogenic diet. Primary endpoint is the acute impact on TKV as determined by MRI volumetry.
KETO-ADPKD: This randomized controlled clinical trial will examine two different ketogenic interventions: (a)3-day water fasting, (b)a ketogenic diet, or (c)ad libitum control over 3 months (n=21 per arm). Patients will be supported by nutritionists and safety will be tightly monitored by monthly visits, blood/urine tests and questionnaires. The primary endpoint is feasibility to answer whether the diets are generally acceptable to ADPKD patients in everyday life, and to identify the intervention showing optimal adherence and sustained ketosis. This intervention will be the basis for future efficacy trials.

Funding

  • KETO-ADPKD is funded by the PKD foundation