A new study has found that a low protein diet (LPD) combined with ketoanalogues (KAs), which are amino acid supplements, significantly slows the progression of chronic kidney disease (CKD) compared to LPD alone. CKD is a long-term condition in which the kidneys do not function properly. It is estimated that CKD has a high prevalence of 11-13% worldwide, with the majority of patients experiencing a decline in kidney function. The main aim of nephrology practice is to develop strategies to delay or avoid dialysis, the standard treatment for advanced CKD.
Nutritional management, particularly restricted protein intake, has been shown to slow CKD progression. Previous studies have demonstrated that a low protein diet is associated with a reduced risk of end-stage kidney disease. The updated Kidney Disease Outcomes Quality Initiative (KDOQI) nutrition guideline recommends considering a very low protein diet (VLPD) supplemented with KAs to further reduce the risk of kidney failure. KAs can replace essential amino acids without producing nitrogen waste products in the body. However, adherence to VLPD regimens may be low in real-world settings.
In this retrospective cohort study, researchers analyzed the data of pre-dialysis CKD patients who followed either an LPD–KAs regimen or an LPD alone. The study found that patients treated with LPD–KAs had a significantly lower risk of kidney function decline and dialysis initiation compared to those on LPD alone. The annual rate of decline in estimated glomerular filtration rate (eGFR) was also lower in the LPD–KAs group. Additionally, the study observed that higher doses of KAs were associated with a greater reduction in risk.
This study provides further evidence that a low protein diet combined with amino acid supplementation can effectively slow the progression of kidney disease. However, future randomized controlled trials are needed to confirm these findings.
Sources:
[Study Title: The Effect of Low Protein Diet with Ketoanalogues on Kidney Function Decline in Chronic Kidney Disease Patients: A Retrospective Cohort Study][1]
Definitions:
Chronic kidney disease (CKD): A long-term condition in which the kidneys do not function properly, leading to a progressive loss of kidney function over time.
Glomerular filtration rate (GFR): A measure of how well the kidneys are filtering waste products from the blood.
Ketoanalogues (KAs): Amino acid supplements that can be used in place of their respective amino acids without producing nitrogen waste products in the body.
[1]: Study Title: The Effect of Low Protein Diet with Ketoanalogues on Kidney Function Decline in Chronic Kidney Disease Patients: A Retrospective Cohort Study
