Very low‐protein diet to postpone renal failure: Pathophysiology and clinical applications in chronic kidney disease

Bellizzi, Vincenzo; Calella, Patrizia; Carrero, Juan Jesús; Fouque, Denis

doi:10.1016/j.cdtm.2018.01.003

Cited by 10 publications

(7 citation statements)

References 38 publications

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“…The principal solutes retained in CKD are the protein related products that cause hyper-azotemia, acidemia, and hyperphosphatemia; phosphate and sodium also play a relevant role in renal adaptation, causing hyperparathyroidism and extracellular volume expansion, respectively [4]. Generally, nutritional management of CKD requires balancing the intake of energy, protein, sodium, potassium, phosphorus, and fluid with biochemical markers and weight change [5].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis

2019

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The effects of ketoanalogues (KA) on chronic kidney disease (CKD) deterioration have not yet been fully confirmed. To strengthen the evidence of the role of KA in CKD, PubMed and Embase were searched for studies published through February 2019. Effect sizes from ten randomized control trials (RCTs) and two non-RCTs comprising a total of 951 patients were pooled and analyzed. A restricted protein diet supplemented with ketoanalogues (RPKA) was found to significantly delay the progression of CKD (p = 0.008), particularly in patients with an estimated glomerular filtration rate (eGFR) > 18 mL/min/1.73 m2 (p < 0.0001). No significant change in eGFR was found when comparing a very-low-protein diet and a low-protein diet (p = 0.10). In addition, compared with the placebo, RPKA did not cause malnutrition (albumin: p = 0.56; cholesterol: p = 0.50). Moreover, RPKA significantly decreased phosphorous levels (p = 0.001), increased calcium levels (p = 0.04), and decreased parathyroid hormone (PTH) levels (p = 0.05) in patients with eGFR < 18 mL/min/1.73 m2. In conclusion, RPKA could slow down the progression of CKD in patients with eGFR > 18 mL/min/1.73 m2 without causing malnutrition and reverse CKD-MBD in patients with eGFR < 18 mL/min/1.73 m2.

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Section: Introductionmentioning

confidence: 99%

The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis

2019

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“…Inversely, LPD supplemented with ketoacids was more effective than LPD alone in protecting kidney function from oxidative stress injury in remnant kidney tissue [20]. As a consequence, VLPD with KA/EAA has been supposed to protect against the progression of CKD and preserve residual renal function, slowing the GFR decline toward end-stage renal disease [21]. Strategies to avoid protein malnutrition include supplementing decreased protein intake with essential amino acids for CKD populations.…”

Section: Discussionmentioning

confidence: 99%

Very low protein diet plus ketoacid analogs of essential amino acids supplement to retard chronic kidney disease progression

Satirapoj

Vongwattana

Supasyndh

2018

Kidney Res Clin Pract.

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BackgroundA very low protein diet (VLPD) with ketoacid analogs of essential amino acids (KA/EAA) administration can remarkably influence protein synthesis and metabolic disturbances of patients with advanced chronic kidney disease (CKD), and may also slow the decline in renal function.MethodsA retrospective cohort study was carried out to monitor renal progression and metabolic and nutritional status among 140 patients with CKD stage III or IV. One group (n = 70) was on a low protein diet (LPD) with 0.6 g of protein intake, and another group (n = 70) was on a VLPD with 0.3 g of protein and KA/EAA supplementation of 100 mg/kg/day for 12 months.ResultsAt 12-month follow-up, estimated glomerular filtration rate (GFR) significantly decreased from 41.6 ± 10.2 to 36.4 ± 8.8 mL/min/1.73 m2 (P < 0.001) and urine protein increased from 0.6 ± 0.5 to 0.9 ± 1.1 g/day (P = 0.017) in the LPD group, but no significant changes in estimated GFR and urine protein were found in the VLPD plus KA/EAA group. A significant mean difference in rate of change in estimated GFR (−5.2 ± 3.6 mL/min/1.73 m2 per year; P < 0.001) was observed between the two groups. After Cox regression analysis, treatment with VLPD plus KA/EAA significantly protected against the incidence of declining GFR > 10% annually (adjusted hazard ratio, 0.42; 95% confidence interval, 0.23–0.79; P = 0.006) and significant correlations were found between using VLPD plus KA/EEA and increased GFR.ConclusionVLPD supplementation with KA/EAA is associated with delayed renal progression while preserving the nutritional status in the patients with CKD. Co-administration of VLPD and KA/EAA may prove an effective alternative to conservative management of CKD.

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“…Protein deficiency or excessive intake can cause metabolic disorders and affect physical health [71]. Excessive intake of plant protein increases kidney load, and excess animal protein intake increases the risk of osteoporosis [72,73]. Conversely, protein deficiency causes a series of diseases such as reduced resistance, slow growth, weight loss, apathy, irritability, anemia, thinness, and edema.…”

Section: Nutrition Levelmentioning

confidence: 99%

Diet and Skin Aging—From the Perspective of Food Nutrition

et al. 2020

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We regularly face primary challenges in deciding what to eat to maintain young and healthy skin, defining a healthy diet and the role of diet in aging. The topic that currently attracts maximum attention is ways to maintain healthy skin and delay skin aging. Skin is the primary barrier that protects the body from external aggressions. Skin aging is a complex biological process, categorized as chronological aging and photo-aging, and is affected by internal factors and external factors. With the rapid breakthrough of medicine in prolonging human life and the rapid deterioration of environmental conditions, it has become urgent to find safe and effective methods to treat skin aging. For diet, as the main way for the body to obtain energy and nutrients, people have gradually realized its importance to the skin. Therefore, in this review, we discuss the skin structure, aging manifestations, and possible mechanisms, summarize the research progress, challenges, possible directions of diet management, and effects of foodborne antioxidants on skin aging from the perspective of food and nutrition.

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Very low‐protein diet to postpone renal failure: Pathophysiology and clinical applications in chronic kidney disease

Cited by 10 publications

References 38 publications

The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis

The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis

Very low protein diet plus ketoacid analogs of essential amino acids supplement to retard chronic kidney disease progression

Diet and Skin Aging—From the Perspective of Food Nutrition

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