International Urology and Nephrology

, Volume 50, Issue 4, pp 687–694 | Cite as

Effect of restricted protein diet supplemented with keto analogues in end-stage renal disease: a systematic review and meta-analysis

  • Zheng Jiang
  • Yi Tang
  • Lichuan Yang
  • Xuhua Mi
  • Wei Qin
Nephrology - Review



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.


Restricted protein diet Keto analogues End-stage renal disease Hemodialysis Peritoneal dialysis Meta-analysis Systematic review 


Author contributions

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.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Division of Nephrology, Department of MedicineThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
  2. 2.West China School of MedicineSichuan UniversityChengduChina
  3. 3.Division of Nephrology, Department of Medicine, West China HospitalSichuan UniversityChengduChina

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