Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet

Jae Hyun Chang, Dong Ki Kim, Jung Tak Park, Ea Wha Kang, TaeHyun Yoo, Beom Seok Kim, Kyu Hun Choi, Ho Yung Lee, Dae Suk Han, Sug Kyun Shin

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Abstract

Aim: A low-protein diet (LPD) is a conservative treatment in patients with chronic kidney disease (CKD) to improve uremic symptoms and slow the progression of renal dysfunction. However, the deleterious effects of protein restriction on nutritional status have raised concern. We investigated whether ketoanalogs supplementation in CKD patients who had training on LPD retards the progression of CKD and maintains nutritional status. Methods: Data were collected retrospectively from 120 consecutive patients in the CKD stages III and IV. Firstly all patients were restricted to LPD alone for 6 months (LPD alone), and then ketoanalogs of essential amino acids (KA) were supplemented for 6 months. Results: The adequate LPD had not achieved in both periods. The declining slopes of glomerular filtration rate (GFR) during the LPD + KA period were significantly lower than those during the LPD alone period. This improvement in GFR was apparent in both subjects with diabetics and non-diabetic patients. Mean serum total cholesterol levels decreased in LPD + KA compared with LPD alone period. However, serum albumin levels did not change. Responders showed a higher prevalence of diabetes and higher serum albumin levels during the LPD alone period. Multivariate analysis revealed that responsiveness to LPD + KA was independently related to diabetes (p = 0.006) and high serum albumin levels (p = 0.011) in the LPD alone period. Conclusion: KA supplementation on over LPD delayed the progression of CKD without deteriorating nutritional status, and initial serum albumin levels could be an independent factor.

Original languageEnglish
Pages (from-to)750-757
Number of pages8
JournalNephrology
Volume14
Issue number8
DOIs
Publication statusPublished - 2009 Dec 1

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Protein-Restricted Diet
Chronic Renal Insufficiency
Serum Albumin
Nutritional Status
Glomerular Filtration Rate
Essential Amino Acids

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Chang, Jae Hyun ; Kim, Dong Ki ; Park, Jung Tak ; Kang, Ea Wha ; Yoo, TaeHyun ; Kim, Beom Seok ; Choi, Kyu Hun ; Lee, Ho Yung ; Han, Dae Suk ; Shin, Sug Kyun. / Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet. In: Nephrology. 2009 ; Vol. 14, No. 8. pp. 750-757.
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Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet. / Chang, Jae Hyun; Kim, Dong Ki; Park, Jung Tak; Kang, Ea Wha; Yoo, TaeHyun; Kim, Beom Seok; Choi, Kyu Hun; Lee, Ho Yung; Han, Dae Suk; Shin, Sug Kyun.

In: Nephrology, Vol. 14, No. 8, 01.12.2009, p. 750-757.

Research output: Contribution to journalArticle

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T1 - Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet

AU - Chang, Jae Hyun

AU - Kim, Dong Ki

AU - Park, Jung Tak

AU - Kang, Ea Wha

AU - Yoo, TaeHyun

AU - Kim, Beom Seok

AU - Choi, Kyu Hun

AU - Lee, Ho Yung

AU - Han, Dae Suk

AU - Shin, Sug Kyun

PY - 2009/12/1

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N2 - Aim: A low-protein diet (LPD) is a conservative treatment in patients with chronic kidney disease (CKD) to improve uremic symptoms and slow the progression of renal dysfunction. However, the deleterious effects of protein restriction on nutritional status have raised concern. We investigated whether ketoanalogs supplementation in CKD patients who had training on LPD retards the progression of CKD and maintains nutritional status. Methods: Data were collected retrospectively from 120 consecutive patients in the CKD stages III and IV. Firstly all patients were restricted to LPD alone for 6 months (LPD alone), and then ketoanalogs of essential amino acids (KA) were supplemented for 6 months. Results: The adequate LPD had not achieved in both periods. The declining slopes of glomerular filtration rate (GFR) during the LPD + KA period were significantly lower than those during the LPD alone period. This improvement in GFR was apparent in both subjects with diabetics and non-diabetic patients. Mean serum total cholesterol levels decreased in LPD + KA compared with LPD alone period. However, serum albumin levels did not change. Responders showed a higher prevalence of diabetes and higher serum albumin levels during the LPD alone period. Multivariate analysis revealed that responsiveness to LPD + KA was independently related to diabetes (p = 0.006) and high serum albumin levels (p = 0.011) in the LPD alone period. Conclusion: KA supplementation on over LPD delayed the progression of CKD without deteriorating nutritional status, and initial serum albumin levels could be an independent factor.

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