Calderón-Juárez Martín, Saavedra-Fuentes Nadia, Del Castillo-Loreto Karla Guadalupe, Castillo-Salinas Juan Carlos, Lerma Claudia
Faculty of Sciences, Universidad Nacional Autónoma de México, Coyoacan 04510, Mexico.
Centro Medico Dalinde, Mexico City 06760, Mexico.
Life (Basel). 2024 Dec 10;14(12):1638. doi: 10.3390/life14121638.
The addition of ketoanalogues (KAs) to a low-protein diet has been shown to mitigate the progression of pre-dialysis chronic kidney disease (CKD). The addition of inulin and calcium citrate may add further benefits, given their nephroprotective effects. In this study, we tested the changes in estimated glomerular filtration rate (eGFR), CKD symptoms, body composition, and biochemical parameters after 6 months of diet supplementation with Cetolán III, a combination of KA, inulin, and calcium citrate. We included 76 adult patients diagnosed with CKD stages 3 and 4 and not treated with renal replacement therapy in a retrospective cohort. In this cohort, participants were followed through two clinic visits at 3 and 6 months after diet supplementation. We found a slight increase in eGFR at 3 and 6 months compared with baseline, as well as a decrease in the severity of CDK-related symptoms, fat mass, and muscle mass. We observed only a slight decrease in creatinine and uric acid after 6 months of follow-up. We did not find a remarkable change in anthropometric parameters (e.g., body mass index, waist circumference, and arm muscle area). This observational study suggests that addition of KA, inulin, and calcium citrate to a low protein- diet could be associated with an improvement in eGFR and symptom severity in CKD pre-dialysis.
已证明在低蛋白饮食中添加酮类似物(KAs)可减缓透析前慢性肾脏病(CKD)的进展。鉴于菊粉和柠檬酸钙具有肾脏保护作用,添加它们可能会带来更多益处。在本研究中,我们测试了用Cetolán III(一种KA、菊粉和柠檬酸钙的组合)进行6个月饮食补充后,估计肾小球滤过率(eGFR)、CKD症状、身体成分和生化参数的变化。我们纳入了76例诊断为CKD 3期和4期且未接受肾脏替代治疗的成年患者,进行回顾性队列研究。在这个队列中,参与者在饮食补充后的3个月和6个月通过两次门诊就诊进行随访。我们发现,与基线相比,3个月和6个月时eGFR略有增加,同时CDK相关症状的严重程度、脂肪量和肌肉量有所下降。随访6个月后,我们仅观察到肌酐和尿酸略有下降。我们未发现人体测量参数(如体重指数、腰围和上臂肌肉面积)有显著变化。这项观察性研究表明,在低蛋白饮食中添加KA、菊粉和柠檬酸钙可能与改善CKD透析前患者的eGFR和症状严重程度有关。