Centro Medico Dalinde, Mexico City 06760, Mexico.
Hospital Trinidad, Mexico City 06760, Mexico.
Nutrients. 2024 Sep 2;16(17):2930. doi: 10.3390/nu16172930.
Current treatment for chronic kidney disease (CKD) focuses on improving manifestations and delaying progression. Nutritional approaches play a crucial role in CKD management, and various supplements have become available. Ketoanalogues of amino acids (KAs), calcium citrate, and inulin have been proposed as suitable supplements, yet their widespread use has been limited due to insufficient evidence. This study aimed to generate general guidance statements on the appropriateness of these supplements through a RAND/UCLA consensus process.
A RAND/UCLA consensus panel was convened to evaluate the appropriateness of these supplements in different clinical scenarios. In this study, we present a subgroup analysis focusing on a panel of eleven clinical nephrologists from among the experts.
Supplementation of low-protein diets (LPDs) and very low-protein diets (VLPDs) with KA was considered appropriate to reduce manifestations and delay CKD outcomes, supplementation with calcium citrate is considered appropriate to reduce CKD manifestations, and supplementation with inulin is considered appropriate to delay CKD outcomes and manage comorbidities.
Based on a combination of clinical experience and scientific evidence, the panel reached a consensus that KA supplementation of LPD and VLPD, calcium citrate, and inulin are appropriate in patients with CKD across various scenarios.
目前，慢性肾脏病（CKD）的治疗重点在于改善表现并延缓进展。营养方法在 CKD 管理中起着至关重要的作用，各种补充剂也已面世。氨基酸的酮类似物（KAs）、柠檬酸钙和菊粉已被提议作为合适的补充剂，但由于证据不足，其广泛应用受到限制。本研究旨在通过 RAND/UCLA 共识过程生成关于这些补充剂适当性的一般指导陈述。
召集了 RAND/UCLA 共识小组，以评估这些补充剂在不同临床情况下的适当性。在本研究中，我们展示了一项针对专家组中 11 名临床肾病学家的小组分析。
用 KA 补充低蛋白饮食（LPD）和极低蛋白饮食（VLPD）被认为可适当减少 CKD 表现并延缓其结果，补充柠檬酸钙被认为可适当减少 CKD 表现，而补充菊粉被认为可适当延缓 CKD 结果并控制合并症。
基于临床经验和科学证据的综合考虑，专家组达成共识，认为在各种情况下，KA 补充 LPD 和 VLPD、柠檬酸钙和菊粉均适用于 CKD 患者。
