Effects of a Supplemented Hypoproteic Diet in Chronic Kidney Disease

Mircescu, Gabriel; Gârneaţă, Liliana; Sica, Simona; Căpuşă, Cristina

doi:10.1053/j.jrn.2006.12.012

Cited by 92 publications

(109 citation statements)

References 28 publications

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“…Based on the interventions and comparisons, the included studies were divided into the following groups: (i) those comparing LPD with higher‐protein diets10, 17, 18, 19, 20, 21, 22, 23, 24; (ii) those comparing VLPD with LPD10, 25, 26, 27, 28, 29, 30; and (iii) those involving other comparisons31, 32 ( Table 1). As all studies were not similar in their recruited patients and/or outcome measures, not all studies in each category were meta‐analysed ( Figures 2 and 3).…”

Section: Resultsmentioning

confidence: 99%

“…Even though the latter is of immense clinical importance, many clinicians often encounter patients in very late stages of CKD, for example, estimated GFR < 25 mL/min/1.73m 2 , who wish to avoid or defer dialysis therapy by any means possible. Several individual trials17, 18, 22, 23, 24, 25, 26, 27, 28, 29, 30, 34 as well as meta‐analysis studies12, 35, 36, 37 have shown the benefits of protein restriction for such conservative management of CKD patients 38…”

Section: Discussionmentioning

confidence: 99%

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Low‐protein diet for conservative management of chronic kidney disease: a systematic review and meta‐analysis of controlled trials

Rhee

Ahmadi

Kövesdy

et al. 2017

J cachexia sarcopenia muscle

167

126

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BackgroundRecent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low‐protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein‐energy wasting or cachexia. We aimed to systematically review and meta‐analyse the controlled clinical trials with adequate participants in each trial, providing rigorous contemporary evidence of the impact of a low‐protein diet in the management of uraemia and its complications in patients with CKD.MethodsWe searched MEDLINE (PubMed) and other sources for controlled trials on CKD to compare clinical management of CKD patients under various levels of dietary protein intake or to compare restricted protein intake with other interventions. Studies with similar patients, interventions, and outcomes were included in the meta‐analyses.ResultsWe identified 16 controlled trials of low‐protein diet in CKD that met the stringent qualification criteria including having 30 or more participants. Compared with diets with protein intake of >0.8 g/kg/day, diets with restricted protein intake (<0.8 g/kg/day) were associated with higher serum bicarbonate levels, lower phosphorus levels, lower azotemia, lower rates of progression to end‐stage renal disease, and a trend towards lower rates of all‐cause death. In addition, very‐low‐protein diets (protein intake <0.4 g/kg/day) were associated with greater preservation of kidney function and reduction in the rate of progression to end‐stage renal disease. Safety and adherence to a low‐protein diet was not inferior to a normal protein diet, and there was no difference in the rate of malnutrition or protein‐energy wasting.ConclusionsIn this pooled analysis of moderate‐size controlled trials, a low‐protein diet appears to enhance the conservative management of non‐dialysis‐dependent CKD and may be considered as a potential option for CKD patients who wish to avoid or defer dialysis initiation and to slow down the progression of CKD, while the risk of protein‐energy wasting and cachexia remains minimal.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low‐protein diet for conservative management of chronic kidney disease: a systematic review and meta‐analysis of controlled trials

Rhee

Ahmadi

Kövesdy

et al. 2017

J cachexia sarcopenia muscle

167

126

View full text Add to dashboard Cite

show abstract

“…Of the 33 studies, 10 were not isoenergetic [39,41,44,46,64,71,73,75,80,81] and additionally a further three [58,59,77] did not provide sufficient detail to ascertain this. A number of the studies also failed to assess actual intake (as distinct from prescribed intake) [54,56,57,59,61,64,74,78,80]. This is not only relevant for oral diets where intake is voluntary, but also in non-volitional feeding (enteral or parenteral) where intake may be interrupted for various reasons including tube problems, medication administration, surgical procedures, and poor tolerance of the nutrition.…”

Section: Resultsmentioning

confidence: 99%

Back to Basics: Estimating Protein Requirements for Adult Hospital Patients. A Systematic Review of Randomised Controlled Trials

Ferrie¹,

Rand²,

Palmer³

2013

FNS

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Aim: To review the supporting evidence for protein requirements in hospitalised adults, and compare the findings with commonly-used guidelines and resources. Methods: a systematic review was conducted based on a computerised bibliographic search of MEDLINE, EMBASE and CINAHL from 1950 to October 2011, as well as a citation review of relevant articles and guidelines. Studies were included if they were randomised clinical trials in hospitalised or chronically ill adults, comparing two or more different levels of protein intake. Information about study quality, setting, and findings was extracted using standardised protocols. Due to the heterogeneity of study characteristics, no meta-analysis was undertaken. Results: 116 papers were obtained in the search and 33 of these met all inclusion criteria. Five studies could not be obtained. The remainder reported outcome measures such as nitrogen balance, anthropometric measurements (including body weight, BMI, and mid-arm circumference), blood electrolyte levels and serum urea, which provide support for recommended protein intakes in various clinical conditions. The results were summarized and compared with current recommendations. Conclusion: high-level evidence to support current recommendations is lacking. The studies reviewed generally agreed with current guidelines and resources.

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“…In another human research, it was showed that a vegetable proteins diet supplemented with keto-supplement decreased serum urea (Garneata & Mircescu 2013, Mircescu et al 2007). In the present study, however, no statistically significant difference in the values of urea between groups under different therapeutic doses of ketoanalogues were found.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled clinical trial of ketoanalogues supplementation in dogs with chronic kidney disease

et al. 2018

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RESUMO.-[Estudo clínico randomizado controlado da suplementação de cetoanálogos em cães com doença renal crônica.] O objetivo foi de verificar a eficácia da suplementação com cetoanálogos em cães com Doença Renal Crônica (DRC) grau 3. Um ensaio clínico controlado e randomizado foi realizado com 20 cães com DRC grau 3. Os animais foram divididos em 4 grupos: grupo 1 (controle): terapia convencional (TC) para DRC; grupo 2: TC e 60mg/kg, VO, q48h de cetoanálogoa; grupo 3: TC e 60mg/kg, VO, q24h de cetoanálogoa; e grupo 4, TC e 120mg/kg, VO, q12h de cetoanálogoa. Todos os cães receberam ração renal para cães. Os animais foram avaliados no início da terapia e após 15 e 30 dias. Hemograma completo, ureia, creatinina, fósforo, cálcio, potássio e sódio séricos e a razão proteína creatinina (RPC) urinária foram analisados. Foi verificado que o uso dos cetoanálogos em cães com DRC grau 3 durante 30 dias não mostrou eficácia, em nenhuma das dosagens utilizadas, em melhorar os sinais clínicos e sintomatologia da doença, os valores do hemograma e ureia e creatinina séricos, normalizar eletrólitos e reduzir RPC. Concluiu-se que o uso de cetoanálogos

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Effects of a Supplemented Hypoproteic Diet in Chronic Kidney Disease

Cited by 92 publications

References 28 publications

Low‐protein diet for conservative management of chronic kidney disease: a systematic review and meta‐analysis of controlled trials

Low‐protein diet for conservative management of chronic kidney disease: a systematic review and meta‐analysis of controlled trials

Back to Basics: Estimating Protein Requirements for Adult Hospital Patients. A Systematic Review of Randomised Controlled Trials

Randomized controlled clinical trial of ketoanalogues supplementation in dogs with chronic kidney disease

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