Effect of restricted protein diet supplemented with keto analogues in end-stage renal disease: a systematic review and meta-analysis
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To evaluate the efficacy and safety of the restricted protein diet supplemented with keto analogues when applied in end-stage renal disease (ESRD).
The Cochrane Library, PubMed, Embase, CBM and CENTRAL databases were searched and reviewed up to January 2017. Clinical trials were analyzed using RevMan 5.3 software.
Five randomized controlled trials were selected and included in this study according to our inclusion and exclusion criteria. Changes in serum albumin, PTH, triglyceride, cholesterol, calcium, phosphorus, hemoglobin, Kt/v and CRP before and after treatment were analyzed. Meta-analysis results indicated that, compared with normal protein diet, low-protein diet (LPD) supplemented with keto analogues (sLPD) could improve serum albumin (P < 0.00001), hyperparathyroidism (P < 0.00001) and hyperphosphatemia (P = 0.008). No differences in triglyceride, cholesterol, hemoglobin, Kt/v and CRP were observed between different protein intake groups.
Restricted protein diet supplemented with keto analogues (sLPD) may improve nutritional status and prevent hyperparathyroidism in ESRD patients. The current data were mainly obtained from short-term, single-center trails with small sample sizes and limited nutritional status indexes, indicating a need for further study.
KeywordsRestricted protein diet Keto analogues End-stage renal disease Hemodialysis Peritoneal dialysis Meta-analysis Systematic review
Wei Qin planned the study, analyzed data and assisted in article preparation. Zheng Jiang and Yi Tang searched the literature, selected articles, extracted data, analyzed data and composed the article. Lichuan Yang and Xuhua Mi contributed to the concept, data collection and analysis of this study.
Compliance with ethical standards
Conflict of interest
The authors declare that there are no conflicts of interest.
- 4.Saran R et al (2016) US renal data system 2015 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 67(3 Suppl 1):Svii, S1–Svii S305Google Scholar
- 9.Liang J et al (2015) The Effect of α-Ketoacid in Treating Dialysis patients. Chin J of Clin Ration Drug Use 8(5C):120–121 (article in Chinese) Google Scholar
- 10.Zhou S et al (2013) Effect of low protein diet combined a-keto acid on calcium and phosphorus metabolism in patients with maintenance hemodialysis. J Clin Med Pract 17(9):111–113 (article in Chinese) Google Scholar
- 12.Chen W et al (2008) Effects of low-protein diet plus α-keto acid on micro-inflammation and the relationship between micro-inflammation and nutritional status in patients performing continuous ambulatory peritoneal dialysis: a randomized controlled trial. J Chin Integr Med 6(5):473–477CrossRefGoogle Scholar
- 30.Zhang YY, Huang J, Yang M, Gu LJ, Ji JY, Wang LJ, Yuan WJ (2015) Effect of a low-protein diet supplemented with keto-acids on autophagy and inflammation in 5/6 nephrectomized rats. Biosci Rep 35(5). doi: 10.1042/BSR20150069