Long-term effects of ketoanalogues on mortality and renal outcomes in advanced chronic kidney disease patients receiving a low-protein diet

Yi Chun Wang, Shu Hui Juan, Chu Lin Chou, Tsung Cheng Hsieh, Jung Lun Wu, Te Chao Fang

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

The effects of ketoanalogues (KA) supplementation on mortality and progression to dialysis in patients with pre-dialysis stage 5 chronic kidney disease (CKD) receiving a low-protein diet (LPD) remain ambiguous. From Taiwan’s National Health Insurance Research Database during 1996–2011, 165 patients with pre-dialysis CKD on an LPD (0.6 g/kg/day) with KA supplementation were matched with 165 patients with pre-dialysis CKD on an LPD without KA supplementation. Of the 165 patients with advanced CKD receiving KA supplementation, 34 (20.6%) died, and 124 (75.2%) underwent long-term dialysis during the study period. There was no significant difference in mortality between the KA-user group and the KA-nonuser group (adjusted hazard ratio [HR], 1.41; 95% confidence interval [CI], 0.68–2.93; p = 0.355). KA supplementation significantly increased long-term dialysis risk (adjusted HR, 1.41; 95% CI, 1.04–1.90; p = 0.025) and combined outcome risk (defined as long-term dialysis and death; adjusted HR, 1.37; 95% CI, 1.02–1.83; p = 0.034). KA supplementation also increased long-term dialysis risk (adjusted HR, 1.49; 95% CI, 1.00–2.20; p = 0.048) in the subgroup of pre-dialysis patients with diabetes mellitus (DM), but not in those patients without DM. In conclusion, KA supplementation might increase long-term dialysis risk in patients with advanced CKD receiving an LPD, but it did not increase mortality.

Original languageEnglish
Article number2708
Pages (from-to)1-11
Number of pages11
JournalNutrients
Volume12
Issue number9
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Advanced chronic kidney disease
  • Ketoanalogues
  • Low-protein diet

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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