PS-C23-12: DIETARY INTERVENTION WITH THE PROCESSED LOW PROTEIN GENMAI (BROWN RICE) AGAINST CHRONIC KIDNEY DISEASE.

Abstract

Background: Although protein-restricted diets have shown to preserve the renal function, there are a couple of challenges such as (1) the intake of vegetable protein, which is useful for maintaining renal function, is insufficient due to potassium restriction, and (2) caloric intake tends to be inadequate. Therefore, we investigated the effects of diets that may solve these problems with maintaining the current dietary restrictions and may also be additional effects on renal protection. Another study also has shown that patients with CKD are under a chronic inflammatory state and those uremic toxins produced by the gut microbiota are the causes of increased inflammatory cytokine production. We sought to intervene in renal function via modulating this kidney-gut axis in CKD. We thus focused on the processed low protein genmai (brown rice) (PLPG), marketed since 2018 by Follica Foods, Inc. as a candidate food that retains the fiber and GABA characteristic of brown rice, reduces protein to less than 20% of conventional rice, and also limits potassium and phosphorus. Methods: The study was conducted in a before-and-after trial. Thirty patients with eGFR of 59 or less were recruited. PLPG was a retort pack of 150 g for one meal. The patients ate provided with about 10 servings of PLPG per week for 3 months. Results: One patient withdrew due to poor health after participation, and a final total of 29 patients were analyzed. The median age of the participants was 73 years, the mean eGFR was 35.41 ml/min/1.73 m2. The median in BMI decreased by -0.31 (P = 0.037). The median change in the Constipation scoring system score improved by -1.00 (P = 0.032). The change in eGFRcreat decreased with a mean value of -1.241 ml/min/1.73 m2. (P = 0.044), but the monthly eGFRcreat slope was not significantly different. Indoxyl sulfate did not differ significantly, but it showed a decreasing trend with a median change of -0.20 (P = 0.050). The median change in IL-6 was 0.300 pg/mL (P = 0.004). Among short-chain fatty acids, only acetic acid showed an increase with a median change of 7.401 μmol/g (P = 0.010). Conclusion: Participants’ protein intake did not decrease. Therefore, it was thought that the effects of PLPG itself was observed, independent of the effect of low protein. The increase in acetic acid may have contributed to this change. The decrease in e-GFR along with the decrease in urinary protein levels indicated an initial dip due to correction of glomerular hypertension. Long-term follow-up is plausible to establish the novel dietary treatment.