Fo012vegetarian Severe Hypoproteic Diet Supplemented With Keto-Analogues for Predialysis Chronic Kidney Disease Patients: The Influence on Long Term Prognosis

Gârneaţă, Liliana; Mocanu, Carmen Antonia; Mocanu, Andreea; Simionescu, Tudor Petrisor; Firta, Ana Maria; Jafal, Mugurel; Mircescu, Gabriel

doi:10.1093/ndt/gfz096.fo012

Cited by 6 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, significantly less patients in the sVLPD group required KRT at follow-up (51% versus 93%). In patients (still) not on RRT, the adherence to the nutritional intervention remained very good throughout the follow-up in both groups, and there were no changes in the nutritional status in any arm [ 14 ]. A recent meta-analysis confirmed that interventions combining protein restriction with KA/EAA supplementation had a significant role in delaying CKD progression [ 15 ].…”

Section: Protein-restricted Diets With Kas/eaas: Effects On Ckd Progr...mentioning

confidence: 99%

The Microbiome and Protein Carbamylation: Potential Targets for Protein-Restricted Diets Supplemented with Ketoanalogues in Predialysis Chronic Kidney Disease

et al. 2023

Self Cite

View full text Add to dashboard Cite

In chronic kidney disease (CKD), metabolic derangements resulting from the interplay between decreasing renal excretory capacity and impaired gut function contribute to accelerating disease progression and enhancing the risk of complications. To protect residual kidney function and improve quality of life in conservatively managed predialysis CKD patients, current guidelines recommend protein-restricted diets supplemented with essential amino acids (EAAs) and their ketoanalogues (KAs). In clinical studies, such an approach improved nitrogen balance and other secondary metabolic disturbances, translating to clinical benefits, mainly the delayed initiation of dialysis. There is also increasing evidence that a protein-restricted diet supplemented with KAs slows down disease progression. In the present review article, recent insights into the role of KA/EAA-supplemented protein-restricted diets in delaying CKD progression are summarized, and possible mechanistic underpinnings, such as protein carbamylation and gut dysbiosis, are elucidated. Emerging evidence suggests that lowering urea levels may reduce protein carbamylation, which might contribute to decreased morbidity and mortality. Protein restriction, alone or in combination with KA/EAA supplementation, modulates gut dysbiosis and decreases the generation of gut-derived uremic toxins associated, e.g., with cardiovascular disease, inflammation, protein energy wasting, and disease progression. Future studies are warranted to assess the effects on the gut microbiome, the generation of uremic toxins, as well as markers of carbamylation.

show abstract

Section: Protein-restricted Diets With Kas/eaas: Effects On Ckd Progr...mentioning

confidence: 99%

The Microbiome and Protein Carbamylation: Potential Targets for Protein-Restricted Diets Supplemented with Ketoanalogues in Predialysis Chronic Kidney Disease

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Under this umbrella concept, several regimens of HD have been probed: twice-weekly HD with later conversion to thrice-weekly HD dictated by changes in RKF or changes in clinical status in the absence of assessments of RKF; once-weekly HD with low-protein diet followed by later changes to more frequent HD schedules; or thrice-weekly HD with short treatment sessions (<4 hours per session) followed by increase in treatment length ($4 hours per session). 6 Although protein-restricted diets with nitrogen-free ketoacid analogues have been reported as effective and safe means to reduce the rate of kidney function decline and delay dialysis initiation, 7,8 the application of these dietary modifications in patients receiving HD remains to be investigated. Nutrition-related indexes are recognized as strong prognostic factors for all-cause and cardiovascular morbidity and mortality in patients on chronic HD.…”

mentioning

confidence: 99%

Narrative Review of Incremental Hemodialysis

Murea

Moossavi

Gârneaţă

et al. 2020

Kidney International Reports

Self Cite

View full text Add to dashboard Cite

The prescription of hemodialysis (HD) in patients with incident end-stage kidney disease (ESKD) is fundamentally empirical. The abrupt transition from nondialysis chronic kidney disease (CKD) to thriceweekly in-center HD of much the same dialysis intensity as in those with prevalent ESKD underappreciates the progressive nature of kidney disease whereby the decline in renal function has been gradual and ongoing-including at the time of HD initiation. Adjuvant pharmacologic treatment (i.e., diuretics, acid buffers, potassium binders), coupled with residual kidney function (RKF), can complement an initial HD regimen of lower intensity. Barriers to less intensive HD in incident ESKD include risk of inadequate clearance of uremic toxins due to variable and unexpected loss of RKF, lack of patient adherence to assessments of RKF or adjustment of HD intensity, increased burden for all stakeholders in the dialysis units, and negative financial repercussions. A stepped dialysis regimen with scheduled transition from time-delineated twice-weekly HD to thrice-weekly HD could represent an effective and safe strategy to standardize incremental HD in patients with CKD transitioning to early-stage ESKD. Patients' adherence and survival as well as other clinical outcomes should be rigorously evaluated in clinical trials before largescale implementation of different incremental schedules of HD. This review discusses potential benefits of and barriers to alternative dialysis regimens in patients with incident ESKD, with emphasis on twiceweekly HD with pharmacologic therapy, and summarizes in-progress clinical trials of incremental HD schedules.

show abstract

Economic Analysis of a Ketoanalogue-supplemented Very Low-protein Diet in Patients With Chronic Kidney Disease in Vietnam

Huynh

Nguyen

Povero³

et al. 2023

Clinical Therapeutics

View full text Add to dashboard Cite

Fo012vegetarian Severe Hypoproteic Diet Supplemented With Keto-Analogues for Predialysis Chronic Kidney Disease Patients: The Influence on Long Term Prognosis

Cited by 6 publications

References 0 publications

The Microbiome and Protein Carbamylation: Potential Targets for Protein-Restricted Diets Supplemented with Ketoanalogues in Predialysis Chronic Kidney Disease

The Microbiome and Protein Carbamylation: Potential Targets for Protein-Restricted Diets Supplemented with Ketoanalogues in Predialysis Chronic Kidney Disease

Narrative Review of Incremental Hemodialysis

Economic Analysis of a Ketoanalogue-supplemented Very Low-protein Diet in Patients With Chronic Kidney Disease in Vietnam

Contact Info

Product

Resources

About