| Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients. | |
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MedLine Citation:
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PMID: 15354199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the effects on the nutritional and metabolic parameters of a very-low-protein diet supplemented with ketoacids (VLPD+KA) in comparison with a conventional low-protein diet (LPD) in chronic kidney disease (CKD) patients. DESIGN: Prospective, randomized, controlled clinical study. SETTING: Outpatient Clinic of the Nephrology Division of Federal University of Sao Paulo, Brazil. SUBJECTS: The study involved 24 patients with advanced CKD (creatinine clearance <25 ml/min) that were randomly assigned to either a VLPD+KA (VLPD+KA group, 12 patients) or to a conventional LPD with 0.6 g/kg/day (LPD group, 12 patients). The patients were followed for 4 months. RESULTS: Nutritional status was adequately maintained with both diets for the studied period. Protein intake and serum urea nitrogen decreased significantly only in the VLPD+KA group (from 0.68+/-0.17 to 0.43+/-0.12 g/kg/day, P<0.05; from 61.4+/-12.8 to 43.6+/-14.9 mg/dl, P<0.001; respectively). Ionized calcium did not change in the VLPD+KA group but tended to decrease in the LPD group. Serum phosphorus tended to decrease in the VLPD+KA group probably as a result of a significant reduction in dietary phosphorus (529+/-109 to 373+/-125 mg/day, P<0.05) associated to the phosphorus-binding effect of the ketoacids. No change in these parameters was found in the LPD group. Serum parathormone increased significantly only in the LPD group (from 241+/-138 to 494+/-390 pg/ml, P<0.01). The change in PTH concentration was negatively correlated with changes in ionized calcium concentration (r=-0.75, P=0.02) and positively correlated with changes in serum phosphorus (r=0.71, P=0.03) only in the LPD group. CONCLUSION: This study indicates that a VLPD+KA can maintain the nutritional status of the patients similarly to a conventional LPD. Besides, an improvement in calcium and phosphorus metabolism and a reduction in serum urea nitrogen were attained only with the VLPD+KA. Thus, VLPD+KA can constitute another efficient therapeutic alternative in the treatment of CKD patients. |
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Authors:
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S F Feiten; S A Draibe; R Watanabe; M R Duenhas; A C Baxmann; F B Nerbass; L Cuppari |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of clinical nutrition Volume: 59 ISSN: 0954-3007 ISO Abbreviation: Eur J Clin Nutr Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2004-12-16 Completed Date: 2005-04-08 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804070 Medline TA: Eur J Clin Nutr Country: England |
Other Details:
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Languages: eng Pagination: 129-36 Citation Subset: IM |
Affiliation:
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Nutrition Program, Federal University of São Paulo, São Paulo, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Urea Nitrogen Calcium / metabolism Diet, Protein-Restricted / methods* Female Humans Keto Acids / administration & dosage, therapeutic use* Kidney Failure, Chronic / diet therapy*, metabolism Male Middle Aged Nutritional Status Phosphorus / metabolism Prospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Keto Acids; 7440-70-2/Calcium; 7723-14-0/Phosphorus |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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