SAT-270 Results from the Chronic Kidney Disease Observational Database (CKDOD), India

Abstract

Protein restricted diets (PRD) with or without ketoanalogue (KA) supplementation are an established treatment option in chronic kidney disease (CKD). Although their efficacy for slowing down decline of CKD has been shown in randomized controlled trials, implementation to clinical practice has not been investigated in detail in developing countries like India. The aim of this study was to examine utilization and effectiveness of PRD with or without KA supplementation in a real world setting. This observational study was a subcohort of eight Indian centers that participated in the CKDOD study (Shah et al. BMC Nephrol 2015;16:215). Data from routine care were documented between Jun 2010 and Dec 2017. Dietary patterns were analyzed in their relationship with progression of CKD assessed by eGFR decline over time using a mixed effects regression model. 1383 patients were enrolled. The most common dietary interventions were low protein diet (LPD, 0.6-0.8 g/kg) with or without KA supplementation (n = 412, 42%) and no PRD (n = 576, 58%). These patients (LPD or no PRD) were on average 56+/-14 years old (median 58 [47; 66]). 66% were male, 34% female. Most of them were in CKD stage 4 (339, 34%) and 5 (265, 27%). Their main underlying causes of CKD were diabetes mellitus (353, 36%) and hypertension (473, 48%). 54 LPD patients received KA supplementation at enrollment. Figure 1 shows the distribution of dietary protocols stratified by CKD stages (n per stage: 1:10, 2:22, 3A:85, 3B:225, 4:339, 5:265).eGFR changeView Large Image Figure ViewerDownload Hi-res image Download (PPT) The most common PRD in this selected cohort of Indian CKD patients was LPD. LPD was supplemented with KA for some but not all patients in later stages of CKD. Analysis of eGFR decline suggests that a potential beneficial effect of a KA-supplemented LPD might be applicable to routine care in India.