Kleinová Patrícia, Blichová Tímea, Graňák Karol, Kollár Andrej, Vnučák Matej, Dedinská Ivana
Transplant-Nephrology Department, University Hospital Martin, Kollárova 2, 036 01 Martin, Slovakia.
Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia.
Nutrients. 2024 Nov 22;16(23):4001. doi: 10.3390/nu16234001.
Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use of this method in patients with chronic kidney disease and a kidney transplantation. This was a retrospective monocentric study conducted by the transplant nephrology department in Martin, in which patients with chronic kidney disease, with or without kidney transplant therapy, who received a low-protein diet and supplementation with keto analogues were included ( = 59). The changes in their glomerular filtration rate, proteinemia, calcaemia, weight, and glycaemia and the side effects associated with a low-protein diet and keto analogue use were studied in the patients with chronic kidney disease with or without kidney transplantation. The kidney transplant recipients had a significantly more advanced stage of chronic kidney disease ( = 0.0001) than the non-transplanted patients at the time of the prescription of the keto analogues ( = 0.0001). Furthermore, the kidney transplant recipients had a significantly longer follow-up period ( = 0.0001), with a difference of 27 months within subgroups. During the observed period, we recorded a decrease in glomerular filtration, but without statistical significance. In our group, we did not confirm a significant occurrence of adverse effects associated with a low-protein diet and keto analogues. Keto analogues reduce the progression of chronic kidney disease and stabilise glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with keto analogues is effective and safe for kidney transplant recipients after kidney transplantation.
酮类似物与(极低)低蛋白饮食联合使用可显著降低终末期肾病的进展。它们对肾移植受者的益处和安全性问题仍然存在。本研究旨在表明该方法在慢性肾病和肾移植患者中使用的肾脏保护作用和安全性。这是一项由马丁移植肾脏病科进行的回顾性单中心研究,纳入了接受低蛋白饮食并补充酮类似物的慢性肾病患者,无论是否接受肾移植治疗(n = 59)。研究了慢性肾病患者(无论是否接受肾移植)的肾小球滤过率、蛋白尿、血钙、体重和血糖的变化以及与低蛋白饮食和使用酮类似物相关的副作用。在开具酮类似物处方时,肾移植受者的慢性肾病阶段明显比未移植患者更严重(P = 0.0001)。此外,肾移植受者的随访期明显更长(P = 0.0001),亚组内相差27个月。在观察期内,我们记录到肾小球滤过率下降,但无统计学意义。在我们的研究组中,未证实与低蛋白饮食和酮类似物相关的不良反应有显著发生。酮类似物可降低慢性肾病的进展并稳定慢性肾病患者的肾小球滤过率。根据我们的分析,肾移植后用酮类似物治疗对肾移植受者是有效且安全的。