Cargando…

Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet

The effects of ketoanalogues (KA) supplementation on mortality and progression to dialysis in patients with pre-dialysis stage 5 chronic kidney disease (CKD) receiving a low-protein diet (LPD) remain ambiguous. From Taiwan’s National Health Insurance Research Database during 1996–2011, 165 patients...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Yi-Chun, Juan, Shu-Hui, Chou, Chu-Lin, Hsieh, Tsung-Cheng, Wu, Jung-Lun, Fang, Te-Chao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551296/
https://www.ncbi.nlm.nih.gov/pubmed/32899821
http://dx.doi.org/10.3390/nu12092708
_version_ 1783593153221099520
author Wang, Yi-Chun
Juan, Shu-Hui
Chou, Chu-Lin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
Fang, Te-Chao
author_facet Wang, Yi-Chun
Juan, Shu-Hui
Chou, Chu-Lin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
Fang, Te-Chao
author_sort Wang, Yi-Chun
collection PubMed
description The effects of ketoanalogues (KA) supplementation on mortality and progression to dialysis in patients with pre-dialysis stage 5 chronic kidney disease (CKD) receiving a low-protein diet (LPD) remain ambiguous. From Taiwan’s National Health Insurance Research Database during 1996–2011, 165 patients with pre-dialysis CKD on an LPD (0.6 g/kg/day) with KA supplementation were matched with 165 patients with pre-dialysis CKD on an LPD without KA supplementation. Of the 165 patients with advanced CKD receiving KA supplementation, 34 (20.6%) died, and 124 (75.2%) underwent long-term dialysis during the study period. There was no significant difference in mortality between the KA-user group and the KA-nonuser group (adjusted hazard ratio [HR], 1.41; 95% confidence interval [CI], 0.68–2.93; p = 0.355). KA supplementation significantly increased long-term dialysis risk (adjusted HR, 1.41; 95% CI, 1.04–1.90; p = 0.025) and combined outcome risk (defined as long-term dialysis and death; adjusted HR, 1.37; 95% CI, 1.02–1.83; p = 0.034). KA supplementation also increased long-term dialysis risk (adjusted HR, 1.49; 95% CI, 1.00–2.20; p = 0.048) in the subgroup of pre-dialysis patients with diabetes mellitus (DM), but not in those patients without DM. In conclusion, KA supplementation might increase long-term dialysis risk in patients with advanced CKD receiving an LPD, but it did not increase mortality.
format Online
Article
Text
id pubmed-7551296
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-75512962020-10-16 Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet Wang, Yi-Chun Juan, Shu-Hui Chou, Chu-Lin Hsieh, Tsung-Cheng Wu, Jung-Lun Fang, Te-Chao Nutrients Article The effects of ketoanalogues (KA) supplementation on mortality and progression to dialysis in patients with pre-dialysis stage 5 chronic kidney disease (CKD) receiving a low-protein diet (LPD) remain ambiguous. From Taiwan’s National Health Insurance Research Database during 1996–2011, 165 patients with pre-dialysis CKD on an LPD (0.6 g/kg/day) with KA supplementation were matched with 165 patients with pre-dialysis CKD on an LPD without KA supplementation. Of the 165 patients with advanced CKD receiving KA supplementation, 34 (20.6%) died, and 124 (75.2%) underwent long-term dialysis during the study period. There was no significant difference in mortality between the KA-user group and the KA-nonuser group (adjusted hazard ratio [HR], 1.41; 95% confidence interval [CI], 0.68–2.93; p = 0.355). KA supplementation significantly increased long-term dialysis risk (adjusted HR, 1.41; 95% CI, 1.04–1.90; p = 0.025) and combined outcome risk (defined as long-term dialysis and death; adjusted HR, 1.37; 95% CI, 1.02–1.83; p = 0.034). KA supplementation also increased long-term dialysis risk (adjusted HR, 1.49; 95% CI, 1.00–2.20; p = 0.048) in the subgroup of pre-dialysis patients with diabetes mellitus (DM), but not in those patients without DM. In conclusion, KA supplementation might increase long-term dialysis risk in patients with advanced CKD receiving an LPD, but it did not increase mortality. MDPI 2020-09-04 /pmc/articles/PMC7551296/ /pubmed/32899821 http://dx.doi.org/10.3390/nu12092708 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Yi-Chun
Juan, Shu-Hui
Chou, Chu-Lin
Hsieh, Tsung-Cheng
Wu, Jung-Lun
Fang, Te-Chao
Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title_full Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title_fullStr Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title_full_unstemmed Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title_short Long-Term Effects of Ketoanalogues on Mortality and Renal Outcomes in Advanced Chronic Kidney Disease Patients Receiving a Low-Protein Diet
title_sort long-term effects of ketoanalogues on mortality and renal outcomes in advanced chronic kidney disease patients receiving a low-protein diet
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551296/
https://www.ncbi.nlm.nih.gov/pubmed/32899821
http://dx.doi.org/10.3390/nu12092708
work_keys_str_mv AT wangyichun longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet
AT juanshuhui longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet
AT chouchulin longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet
AT hsiehtsungcheng longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet
AT wujunglun longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet
AT fangtechao longtermeffectsofketoanaloguesonmortalityandrenaloutcomesinadvancedchronickidneydiseasepatientsreceivingalowproteindiet