Abstract: FR-PO0363
Reversal of eGFR Decline in Stage 3 CKD with Carbohydrate-Restricted Nutrition Therapy: A Real-World, Long-Term Retrospective Analysis
Session Information
- Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Weimbs, Thomas, University of California Santa Barbara, Santa Barbara, California, United States
- Athinarayanan, Shaminie J, Virta Health Corp, Denver, Colorado, United States
- Roberts, Caroline G. P., Virta Health Corp, Denver, Colorado, United States
- Shetty, Greeshma K, Virta Health Corp, Denver, Colorado, United States
- Adams, Rebecca N, Virta Health Corp, Denver, Colorado, United States
- Zoller, Alison, Virta Health Corp, Denver, Colorado, United States
- Friedman, Allon N., Indiana University School of Medicine, Indianapolis, Indiana, United States
Background
Diseases of insulin resistance carry higher risk of chronic kidney disease (CKD). Human studies suggest carbohydrate-restricted nutrition therapy (CRNT) may offer renoprotective effects. Virta’s telemedicine clinic, which delivers CRNT, has been shown to improve glycemia and cardio-renal-metabolic outcomes.
Methods
Here, we investigated whether Virta’s CRNT program may affect long-term renal outcomes in patients with moderate/advanced CKD (stage 3) in a real-world setting. 1567 individuals with stage 3 CKD were included in this retrospective 2-year follow-up study (Table 1). eGFR changes and slope were investigated using linear mixed-effects models.Additionally, changes in albuminuria (UACR) over two years were assessed in a subset of individuals (n=944).
Results
eGFR significantly improved from enrollment to 1 year and remained stable at 2 years in both stage 3a and 3b CKD. Consistent with this improvement, eGFR slope showed a positive change of 3.6 mL/min/1.73m2 per year in individuals with stage 3a eGFR, and 3.1 mL/min/1.73m2 per year in those with stage 3b. UACR levels decreased by approximately 36% (not significant) in the overall subcohort and showed a significant 47% reduction in those who had moderate to significant albuminuria at baseline (A2 or greater).
Conclusion
This real-world, long-term assessment demonstrates that CRNT does not merely slow the progression of CKD but leads to sustained improvement of eGFR and albuminuria. Thus, the observed efficacy of carbohydrate restriction surpasses the known efficacy of any pharmacotherapy for CKD. Prospective clinical trials are needed to assess the long-term impact of CRNT and role in CKD management.