PMID- 32296529
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231113
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 13
IP  - 2
DP  - 2020 Apr
TI  - The low-protein diet for chronic kidney disease: 8 years of clinical experience 
      in a nephrology ward.
PG  - 253-260
LID - 10.1093/ckj/sfz141 [doi]
AB  - BACKGROUND: Guidelines indicate that a low-protein diet (LPD) delays dialysis in 
      severe chronic kidney disease (CKD). We assessed the value of these guidelines by 
      performing a retrospective analysis in our renal clinical practice. METHODS: The 
      analysis was performed from 1 January 2010 to 31 March 2018 in 299 CKD Stage 4 
      patients followed for 70 months in collaboration with a skilled nutritionist. The 
      patients included 43 patients on a controlled protein diet (CPD) of 0.8 g/kg/day 
      [estimated glomerular filtration rate (eGFR) 20-30 mL/min/1.73 m(2) body surface 
      (b.s.)], 171 patients on an LPD of 0.6 g/kg/day and 85 patients on an 
      unrestricted protein diet (UPD) who were not followed by our nutritionist (LPD 
      and UPD, eGFR <20 mL/min/1.73 m(2) b.s.). RESULTS: eGFR was higher in CPD 
      patients than in UPD and LPD patients (21.9 +/- 7.4 mL/min/1.73 m(2) versus 
      17.6 +/- 8.00 mL/min/1.73 m(2) and 17.1 +/- 7.5 mL/min/1.73 m(2); P = 0.008). The 
      real daily protein intake was higher in UPD patients than in LPD and CDP patients 
      (0.80 +/- 0.1 g/kg/day versus 0.6 +/- 0.2 and 0.63 +/- 0.2 g/kg/day; P = 0.01). Body 
      mass index (BMI) was stable in the LPD and CPD groups but decreased from 
      28.5 +/- 4.52 to 25.4 +/- 3.94 kg/m(2) in the UPD group (P < 0.001). The renal 
      survival of UPD, LPD and CPD patients was 47.1, 84.3 and 90.7%, respectively, at 
      30 months (P < 0.001), 42.4, 72.0 and 79.1%, respectively, at 50 months 
      (P < 0.001) and 42.4, 64.1 and 74.4%, respectively, at 70 months (P < 0.001). The 
      LPD patients started dialysis nearly 24 months later than the UPD patients. Diet 
      was an independent predictor of dialysis [-67% of RR reduction (hazard 
      ratio = 0.33; confidence interval 0.22-0.48)] together with a reduction in BMI. 
      CONCLUSIONS: An LPD recommended by nephrologists in conjunction with skilled 
      dietitians delays dialysis and preserves nutritional status in severe CKD.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.
FAU - Baragetti, Ivano
AU  - Baragetti I
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - De Simone, Ilaria
AU  - De Simone I
AD  - Division of Nephrology and Dialysis, Legnano Hospital, ASST Ovest Milanese, 
      Legnano, Milan, Italy.
FAU - Biazzi, Cecilia
AU  - Biazzi C
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Buzzi, Laura
AU  - Buzzi L
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Ferrario, Francesca
AU  - Ferrario F
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Luise, Maria Carmen
AU  - Luise MC
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Santagostino, Gaia
AU  - Santagostino G
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Furiani, Silvia
AU  - Furiani S
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Alberghini, Elena
AU  - Alberghini E
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Capitanio, Chiara
AU  - Capitanio C
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Terraneo, Veronica
AU  - Terraneo V
AD  - Division of Nephrology and Dialysis, Bassini Hospital, ASST Nord Milano, 
      Cinisello Balsamo, Milan, Italy.
FAU - Milia, Vicenzo La
AU  - Milia V
AD  - Division of Nephrology and Dialysis, Manzoni Hospital, ASST Lecco, Lecco (Lecco), 
      Italy.
FAU - Pozzi, Claudio
AU  - Pozzi C
AD  - Salus Medical Center, Lecco, Italy.
LA  - eng
PT  - Journal Article
DEP - 20191108
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
PMC - PMC7147315
OTO - NOTNLM
OT  - dialysis
OT  - low-protein diet
OT  - severe CKD
EDAT- 2020/04/17 06:00
MHDA- 2020/04/17 06:01
PMCR- 2019/11/08
CRDT- 2020/04/17 06:00
PHST- 2019/04/29 00:00 [received]
PHST- 2019/09/13 00:00 [accepted]
PHST- 2020/04/17 06:00 [entrez]
PHST- 2020/04/17 06:00 [pubmed]
PHST- 2020/04/17 06:01 [medline]
PHST- 2019/11/08 00:00 [pmc-release]
AID - sfz141 [pii]
AID - 10.1093/ckj/sfz141 [doi]
PST - epublish
SO  - Clin Kidney J. 2019 Nov 8;13(2):253-260. doi: 10.1093/ckj/sfz141. eCollection 
      2020 Apr.