Title: Low protein diet supplemented with ketoanalogues and its effect on the time progression of CKD. Experience of an interdisciplinary outpatient care group.

E-Poster

https://storage.unitedwebnetwork.com/files/1099/baee66b6ad770c7237eecafbb38cc0c9.pdf

Abstract Title

First Name *

Gabriela

Last Name *

Pomiglio

Co-author 1

Aldana Lizarraga lizarragam407@gmail.com Aterym Dialisis CABA

Co-author 2

Andrea Aimar aimarmariaandrea@gmail.com CENU Dialisis Trenkelauken

Co-author 3

Co-author 4

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Introduction:

A low-protein diet of 0.6 gr/kg/day and adequate calories (35 kcal/kg/day) supplemented with keto-analogues (KA) and a follow-up through a interdisciplinary team can positively influence protein synthesis by controlling metabolic alterations in patients with advanced CKD slowing their progression and preserving their nutritional status.

Our interdisciplinary group has previously published its experience on the clinical and nutritional evolution of patients with CKD stages 3b, 4 and 5 treated with this treatment. In our experience, KA is an promising treatment for delaying the start of renal replacement therapy (RRT) in patients with CKD stages 4 and 5.

Thus, the objective of the present study was to analyze the time elapsed in those Pacients until they required renal replacement therapy. On this occasion, we are presenting the preliminary results of an ongoing study.

Methods

Material and Methods:

An Argentinian multicentric retrospective cohort study including patients who were included had at least 2 years of follow-up with CKD stages 4 and 5, with a follow-up from their start on KA until June 30, 2023, or until treatment suspended to start RRT. Statistical analysis using IBM SPSS v26. Data reported as median, interquartile range and percentage. A difference of α= 0.05 was considered significant.

Results

Results:

During the period of study, 172 patients with CKD stage 4 and 5 were included and had a follow-up. Their median age was 69 (55.5-77) and 65 (57-76) years respectively. 58.6% of patients in stage 4 were over 65 years of age, and 44.4% in stage 5 (TABLE 1). During the follow-up time, only 25,5% of the patients in stage 4 required RRT, and 29,9% of the stage 5 patients (Figure 1). The median follow-up time was 3.34 years for stage 4 and 2.95 years for stage 5. The follow-up time from the start of treatment until admission to RRT was 3.22 (2.49-3.65) in stage 4 and 2.38 (2.18-3.29) in stage 5.

Conclusions

Conclusions:

Preliminary results from our ongoing study show that patients with stage 4 CKD entered RRT at 3.4 years and with stage 5 at 2.38 years when LPD and KA were added to standard treatment. We consider that interdisciplinary follow-up by nephrologists and nutritionists specialized in CKD is essential to achieve therapeutic success

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