The effect of low-protein diet supplemented with ketoacids in patients with chronic renal failure

2009 ◽  
Vol 150 (5) ◽  
pp. 217-224 ◽  
Author(s):  
Márta Molnár ◽  
Margit Szekeresné Izsák ◽  
Judit Nagy ◽  
Mária Figler
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Gault Formula

Ismert, hogy az étrendi fehérjemegszorítás lassítja a krónikus vesebetegség progresszióját. Ha a fehérjebevitel kevesebb mint 0,5-0,6 g/ttkg/nap, a diétát esszenciális aminosavakkal/ketosavakkal szükséges kiegészíteni. A szerzők tanulmányukban a hosszú időn keresztül ketosavakkal kiegészített fehérjeszegény diéta hatását vizsgálták krónikus veseelégtelenségben szenvedő betegekben a veseelégtelenség progressziójára, a kalcium- és foszforanyagcserére, a betegek tápláltsági állapotára, továbbá felmérték a betegek complience-ét. Ötvenegy beteget kezeltek 12–57 hónapig (átlagos kezelési idő: 26 hónap). A szérumkreatinin-érték átlaga 349,72±78,04 µmol/l-ről 460,66±206,66 µmol/l-re emelkedett, amely 27 µmol/l/év, illetve 2,3 µmol/l/hó szérumkreatinin-növekedést jelentett. A Cockroft–Gault-formula alapján számolt glomerulusfiltrációs ráta (GFR) 21,52±7,84 ml/min-ról 18,22±7,76 ml/min-ra csökkent, ami 0,83 ml/min/év, illetve 0,07 ml/min/hó GFR-csökkenést jelentett. Lineáris regressziós analízissel az 1/szérumkreatinin versus időegyenes dőlésszöge 0,0018 volt. A szérumparathormon-szint szignifikánsan csökkent, a szérumkalcium, -foszfor szintje nem változott. A betegek tápláltsági állapota (a BMI, szérumalbumin, szubjektív tápláltsági felmérés alapján) a folyamatos és intenzív diétás edukációnak köszönhetően nem romlott, a betegek tartani tudták az alacsony fehérjetartalmú diétát a kezelés hosszú időtartama alatt. Eredményeik igazolják, hogy a ketosavakkal kiegészített fehérjeszegény diéta hatásos a veseelégtelenség progressziójának csökkentésében, előnyösen befolyásolja a kalcium- és foszforanyagcserét, nem rontja a betegek tápláltsági állapotát.

Comparison of a Vegetable-Based (Soya) and an Animal-Based Low-Protein Diet in Predialysis Chronic Renal Failure Patients

Nephron ◽  
1998 ◽  
Vol 79 (2) ◽  
pp. 173-180 ◽  
Author(s):  
N. Soroka ◽  
D.S. Silverberg ◽  
M. Greemland ◽  
Y. Birk ◽  
M. Blum ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Predialysis Chronic Renal Failure

scholarly journals Survival on dialysis among chronic renal failure patients treated with a supplemented low-protein diet before dialysis.

1995 ◽  
Vol 6 (5) ◽  
pp. 1379-1385
Author(s):  
J Coresh ◽  
M Walser ◽  
S Hill
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Mortality Rate ◽  
Serum Creatinine ◽  
Dietary Treatment ◽  
Mortality Rates ◽  
Protein Restriction ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

Concerns have been raised about the possibility of protein restriction resulting in malnutrition and poor subsequent survival on dialysis. However, no studies have examined patients treated with protein restriction to determine their subsequent survival on dialysis. This study prospectively monitored 67 patients with established chronic renal failure (mean initial serum creatinine of 4.3 mg/dL) who were treated with a very low-protein diet (0.3 g/kg per day) supplemented with either essential amino acids or a ketoacid-amino acid mixture and observed closely for clinical complications. Forty-four patients required dialysis. Once dialysis was started, dietary treatment was no longer prescribed. The cumulative mortality rate during the first 2 yr after starting dialysis was 7% (95% confidence interval, 0 to 16%). During this period, only two deaths occurred compared with 11.5 deaths expected on the basis of national mortality rates adjusted for age, sex, race, and cause of renal disease (P = 0.002). However, the protective effect was limited to the first 2 yr on dialysis. Thereafter, mortality rates increased, resulting in a total of 10 deaths during 96.4 person-years of follow-up, which was not significantly lower than the 14.9 deaths expected (P = 0.25). Extrapolation of sequential serum creatinine measurements made before dietary treatment suggests that the improved survival cannot be due to the early initiation of dialysis. Although the lack of an internal control group and data on dialysis lends uncertainty, the large difference in mortality rate between these patients and the nationwide experience indicates that protein restriction and close clinical monitoring predialysis does not worsen and may substantially improve survival during the first 2 yr on dialysis. These findings point out the importance of studying predialysis treatments as a means for lowering mortality on dialysis.

Low-protein diet in children with chronic renal failure?1-year results

1991 ◽  
Vol 5 (4) ◽  
pp. 496-500 ◽  
Author(s):  
Anne-Margret Wingen ◽  
Claudia Fabian-Bach ◽  
Otto Mehls
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

Low-protein diet and chronic renal failure

The Lancet ◽  
1991 ◽  
Vol 338 (8764) ◽  
pp. 442-444 ◽  
Author(s):  
Giuliano Barsotti ◽  
Sergio Giovannetti ◽  
N. Gretz ◽  
M. Strauch ◽  
Francesco Locatelli ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

No change of hyperleptinemia despite a decrease in insulin concentration in patients with chronic renal failure on a supplemented very low protein diet

2000 ◽  
Vol 36 (6) ◽  
pp. 1201-1206 ◽  
Author(s):  
Valérie de Précigout ◽  
Philippe Chauveau ◽  
Caroline Delclaux ◽  
Wael El Haggan ◽  
Laurence Baillet ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Insulin Concentration ◽  
Low Protein Diet ◽  
Low Protein ◽  
Very Low Protein Diet

scholarly journals Supplemented very low protein diet ameliorates responsiveness to erythropoietin in chronic renal failure

2003 ◽  
Vol 64 (5) ◽  
pp. 1822-1828 ◽  
Author(s):  
Biagio R. Di Iorio ◽  
Roberto Minutolo ◽  
Luca De Nicola ◽  
Vincenzo Bellizzi ◽  
Fausta Catapano ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Very Low Protein Diet

scholarly journals Changes in Nutritional Status of Patients with Chronic Renal Failure on a Low Protein Diet

Nephron ◽  
1993 ◽  
Vol 64 (1) ◽  
pp. 154-154 ◽  
Author(s):  
H.C. Rayner ◽  
P.R. Burton ◽  
S. Bennett ◽  
J. Walls
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Nutritional Status ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein
Sign in / Sign up

Export Citation Format

Share Document