Adherence to ketoacids/essential amino acids-supplemented low protein diets and new indications for patients with chronic kidney disease.

Denis Fouque,Kamyar Kalantar-Zadeh,Vladimir Teplan,William E Mitch,Philippe Chauveau,Joel D Kopple,Jing Chen,Wei Chen,Sj Hwang,Liliana Garneata,Giorgina Piccoli

doi:10.1186/s12882-016-0278-7

Abstract

BackgroundLow protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis.MethodsWe reviewed the recent literature addressing low protein diets supplemented with ketoacids/essential aminoacids prescribed during chronic kidney disease and their effects on metabolic, nutritional and renal parameters since 2013.ResultsWe show new information on how to improve adherence to these diets, on metabolic improvement and delay of the dialysis needs, and preliminary data in chronic kidney disease associated pregnancy. In addition, data on incremental dialysis have been reviewed, as well as potential strategies to reverse protein energy wasting in patients undergoing maintenance dialysis.ConclusionThese recent data help to better identify the use of low protein diets supplemented with ketoacids/essential aminoacids during chronic kidney disease.

Highlights

Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis
A recent analysis of the prevalence of end stage renal disease led to the conclusion that the prevalence of maintenance dialysis has grown more rapidly during the last two decades than predicted [1]
In comparison to pregnant Chronic kidney disease (CKD) women who did not receive LPD for various reasons, the women treated with protein-restrictedKA/essential amino acids (EAA) diets had fewer new-borns that were “small for gestational age” (i.e., 3 of 21 pregnancies) compared to those fed ad libitum (i.e., 7 of 16; p = 0.05) [12]

Summary

Introduction

Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis. Compared to an “early start” dialysis (i.e., when GFR is >10 ml/min), this dietary approach of an KA/EAA supplemented 0.6 g protein/kg/day diet resulted in substantial financial savings [10].

Results

Conclusion