Kidney Week

Abstract: TH-PO414

Time-Restricted Feeding and Autosomal Dominant Polycystic Kidney Disease: A Pilot, Randomized Clinical Trial

Session Information

• Genetic Diseases: Cystic - Therapeutic Investigations and Prognosis
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Steele, Cortney, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Cortney Steele,

• Coleman, Erin R., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Erin R. Coleman,

• George, Diana, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Diana George,

• Farmer-Bailey, Heather, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Heather Farmer-Bailey,

• Ramanathan, Sumana, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Sumana Ramanathan,

• Gregory, Adriana, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Adriana Gregory,

• Wang, Wei, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Wei Wang,

• Gitomer, Berenice Y., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Berenice Y. Gitomer,

• Chonchol, Michel, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Michel Chonchol,

• Thomas, Elizabeth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Elizabeth Thomas,

• Kline, Timothy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Timothy L. Kline,

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak,

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most commonly inherited progressive kidney disease leading to cyst growth.Time-restricted feeding (TRF) is a novel fasting regimen that restricts eating to a particular window (typically 8 hrs/day) which could slow cyst growth based on preclinical models.

Methods

A 12-month, randomized controlled, single-blind, behavioral dietary intervention was utilized to compare TRF vs. a healthy eating advice without TRF control group (HE). Participants underwent baseline and 12-month measurements, including adherence via meal logging (primary outcome), anthropometric measures, blood/urine sampling, and magnetic resonance imaging (MRI) to determine height adjusted total kidney volume (htTKV) and abdominal adiposity (exploratory outcomes). The behavioral intervention sessions were taught by a registered dietician via zoom with classes held weekly for the 1^st month and then monthly. Independent t-tests and Pearson’s bivariate correlations were performed.

Results

Twenty-nine participants were randomized (TRF n=14, HE n=15) including (23 females (F) 48±9 yrs of age (mean±s.d.), body mass index (BMI) 32.0 ±5 kg/m², estimated glomerular filtration rate 75±24 ml/min/1.73m^2, and htTKV 710 [334,1018] ml/m (median [IQR]). 71% (n=10) of TRF and 87% (n=13) of HE participants completed the intervention. The eating window was 9.5±0.2 hours for TRF (60% achieving the 8-hour window) and 12.1±0.1(mean±s.d.) for HE groups (p=0.07). Likelihood to adhere to TRF at 12 months was 8±2 points (10-point likert scale). Both groups lost weight: -3.7 [-8.1,2.6] % and -3.6 [-8.1,-0.4] % (median[IQR]) in the TRF and HE group, respectively. Annual percent change in htTKV was 2.8 [0.8,4.3] % and 4.0 [-2.4,11.5] % in the TRF and HE groups, respectively. Both change in weight (r=0.674, p=0.0002) and change in visceral adipose volume (r=0.54, p=0.009) were positively correlated with change in htTKV.

Conclusion

Both TRF and HE groups lost modest weight after the 12-month intervention. The 8-hour eating window appeared to be difficult to adhere to in the TRF group, although satisfaction of adherence was high. Weight and adiposity loss may be more important drivers of kidney growth than timing of eating.

Funding

• NIDDK Support