International Urology and Nephrology

, Volume 48, Issue 3, pp 409–418 | Cite as

Effect of restricted protein diet supplemented with keto analogues in chronic kidney disease: a systematic review and meta-analysis

  • Zheng Jiang
  • Xiaoyan Zhang
  • Lichuan Yang
  • Zi Li
  • Wei QinEmail author
Nephrology - Original Paper



To evaluate the efficacy and safety of the restricted protein diet (low or very low protein diet) supplemented with keto analogues in the treatment of chronic kidney disease (CKD).


The Cochrane library, PubMed, Embase, CBM and CENTRAL databases were searched and reviewed up to April 2015. Clinical trials were analyzed using RevMan 5.3 software.


Seven random control trials, one cross-over trial and one non-randomized concurrent control trial were selected and included in this study according to our inclusion and exclusion criteria. The changes of eGFR, BUN, Scr, albumin, PTH, triglyceride, cholesterol, calcium, phosphorus and nutrition indexes (BMI, lean body mass and mid-arm muscular circumference) before and after treatment were analyzed. The meta-analysis results indicated that, comparing with normal protein diet, low protein diet (LPD) or very low protein diet (vLPD) supplemented with keto analogues (s(v)LPD) could significantly prevent the deterioration of eGFR (P < 0.001), hyperparathyroidism (P = 0.04), hypertension (P < 0.01) and hyperphosphatemia (P < 0.001). No differences in BUN, Scr, Albumin, triglyceride, cholesterol, hemoglobin, calcium and nutrition indexes were observed between different protein intake groups.


Restricted protein diet supplemented with keto analogues (s(v)LPD) could delay the progression of CKD effectively without causing malnutrition.


Restricted protein diet Keto analogues Chronic kidney disease Meta-analysis Systematic review 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Zheng Jiang
    • 1
  • Xiaoyan Zhang
    • 1
  • Lichuan Yang
    • 2
  • Zi Li
    • 2
  • Wei Qin
    • 2
    Email author
  1. 1.West China School of MedicineSichuan UniversityChengduChina
  2. 2.Division of Nephrology, Department of MedicineWest China Hospital of Sichuan UniversityChengduChina

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