Compliance and feasibility of the ketoacid-supplemented very low protein diet in patients with CKD

Abstract

Objective: To assess the effects of a very low protein diet supplemented with ketoacids on urinary urea nitrogen excretion and kidney function tests, in a randomized controlled clinical trial. Material and methods: Patients with stage 4-5 of CKD treated at a nephrology unit of a general hospital, were randomized to receive Ketosteril® 1 tablet per 5 kg/body weight day and a very low protein diet providing 0.3 g/kg of proteins or only a low protein diet providing 0.6 g/kg of proteins (control group). At baseline and after 16 weeks of treatment, fasting blood, 24 h and spot urine samples were collected. Results: Eighty-nine patients were randomized to the control and 93 to the ketoacids group. Fifty-four and 71 patients in each group, respectively, completed the treatment. Patients in the ketoacids group experienced a significantly higher reduction in urinary urea nitrogen and urine phosphorus excretion. Specifically, serum creatinine and cystatin C, did not change significantly. Conclusions: Patients receiving ketoacids had a greater reduction in urine urea nitrogen excretion during the treatment period which reflects good compliance with the very low protein diet.

Keywords

• Renal failure. Ketoacids. Dietary proteins.