Abstract: SA-PO0883
Efficacy of Intermittent Fasting Combined with Kidney-Specific Low-Protein Supplementation in Reducing Albuminuria Among Overweight Patients with Diabetic Kidney Disease
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Supasyndh, Ouppatham, Phramongkutklao Hospital, Bangkok, Thailand
- Satirapoj, Bancha, Phramongkutklao Hospital, Bangkok, Thailand
- Saraggananda, Patsakorn, Phramongkutklao Hospital, Bangkok, Thailand
Background
Weight loss can attenuate albuminuria in diabetic kidney disease (DKD), but intermittent fasting (IF) may aggravate sarcopenia in chronic kidney disease (CKD). Renal specific low protein supplementation (LPS) may counteract this risk, yet the combined strategy has not been tested in DKD.
Methods
In a 12 weeks, open label, randomized controlled trial, 44 overweight adults with DKD and CKD stages 3b to 4 were assigned 1:1 to IF plus renal specific LPS (ONCE Renal, 360 kcal and 7.2 g protein/day) or standard dietary counseling with identical calorie and protein targets. The IF group followed a 16:8 time restricted eating schedule. The primary endpoint was between group difference in change in urine albumin to creatinine ratio (UACR). Secondary endpoints included changes in body weight, estimated glomerular filtration rate (eGFR), body composition, physical performance, metabolic parameters, and safety.
Results
Forty two patients completed the trial. Baseline characteristics, including BMI (28.4 vs 28.6 kg/m2) and eGFR (31.4 vs 36.1 mL/min/1.73 m2), were generally similar between IF+LPS and control groups. At 12 weeks, UACR decreased by 118.2±298.2 mg/g in the IF+LPS group but increased by 96.6±200.4 mg/g in controls, yielding a between group difference of −214.8 mg/g (95% CI −374.9 to −54.7; P=0.01) and a relative reduction of 25.8% (95% CI −41.1 to −10.4; P=0.002). Body weight fell by 1.1±2.0 kg with IF+LPS vs 0.03±1.0 kg with control (between group −1.08 kg; 95% CI −2.08 to −0.09; P=0.03). eGFR, percentage of muscle mass and fat mass, and appendicular skeletal muscle index remained stable, while sit to stand performance improved significantly in the IF+LPS group (between group −1.42 seconds; 95% CI −2.8 to −0.1; P=0.04). Adherence to IF and LPS was high (86.4% and 92.6%, respectively), and no serious adverse events occurred; minor adverse events were infrequent and similar between groups.
Conclusion
In overweight patients with DKD and stage 3b to 4 CKD, a 12 week program of IF combined with renal specific LPS produced a clinically meaningful reduction in albuminuria and modest weight loss without compromising kidney function or muscle mass and with good tolerability. This low burden, nutrition focused strategy may serve as a practical adjunct to pharmacologic therapy.
Acknowledgment
Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine