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Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide

Chieh-Li Yen1, Kun-Hua Tu2, Ming-Shyan Lin3

  • 1Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan. b9102087@yahoo.com.tw.

Nutrients
|August 12, 2018
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Summary

A ketoanalogue-supplemented low-protein diet (sLPD) shows improved long-term survival and reduced risks of mortality, major adverse cardiovascular and cerebrovascular events (MACCEs), and infection-related death in patients after starting dialysis.

Keywords:
adverse eventschronic kidney diseaseketoacidslow-protein dietnutritionsurvival

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Area of Science:

  • Nephrology
  • Clinical Nutrition
  • Public Health

Background:

  • Ketoanalogue-supplemented low-protein diets (sLPD) are known to postpone dialysis.
  • Limited evidence exists on the long-term survival effects of sLPD after dialysis initiation.

Purpose of the Study:

  • To assess the long-term outcomes of patients treated with sLPD after commencing dialysis.
  • To evaluate the impact of sLPD on all-cause mortality, infection rates, and MACCEs.

Main Methods:

  • Retrospective study using Taiwan's National Health Insurance Research Database (2001-2013).
  • Included patients with end-stage renal disease who received sLPD for over 3 months before dialysis initiation.
  • Propensity score matching was used to compare sLPD and non-sLPD groups.

Main Results:

  • The sLPD group (n=2607) exhibited significantly lower risks of all-cause mortality (HR 0.77) and MACCEs (HR 0.86) compared to the non-sLPD group.
  • Infection-related death risk was also reduced in the sLPD group (HR 0.76).
  • These findings suggest a beneficial effect of sLPD on long-term survival post-dialysis.

Conclusions:

  • sLPD treatment appears safe for patients undergoing dialysis.
  • No long-term negative consequences were observed with sLPD use after dialysis initiation.
  • sLPD may contribute to improved long-term outcomes in end-stage renal disease patients on dialysis.