Imam Mohamed S, Alrasheedi Lama Saud Turki, Alyami Saleh Ali Hassan, Aljamaan Mahdi Mohammed Ahmed, Alnaim Khaled Sami Khaled, Alenzi Hussam Mohsen Ayesh, Alnufeai Nouf Nawaf, Almalki Daad Adnan Saad, Alanazi Abdullah S, Alotaibi Saud Saad Frais, Alshaibani Naif Fahad Mashaan, Abdelrahim Mohamed E A, Mohamed Basma M E
Department of Clinical Pharmacy, National Cancer Institute, Cairo University, Fom El Khalig Square, Kasr Al-Aini Street, Cairo 11796, Egypt.
College of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia.
Medicina (Kaunas). 2025 Feb 28;61(3):423. doi: 10.3390/medicina61030423.
: We conducted a meta-analysis to assess the impact of nitrogen-free substitutes for essential amino acids on the progression of chronic kidney disease (CKD). : A comprehensive literature review conducted up to November 2024 identified 15 studies that involved 1596 participants with CKD at baseline; among them, 797 were on very-low-protein diets (LPDs) enriched with nitrogen-free analogs (NFA), while 799 followed a standard LPD. : A very-LPD utilizing NFA showed significantly improved estimated glomerular filtration rate (MD, 1.00; 95% CI, 0.35-1.64, = 0.002), reduced serum creatinine (MD, -0.44; 95% CI, -0.75 to -0.13, = 0.006), decreased blood urea nitrogen (MD, -35.34; 95% CI, -64.27 to -6.42, = 0.02), and lower parathyroid hormone levels (MD, -1.25; 95% CI, -2.33 to 0.18, = 0.02) when compared to a standard LPD in patients with CKD. Nevertheless, the very-LPD with NFA resulted in no significant differences in serum albumin (MD, 0.08; 95% CI, -0.03 to 0.19, = 0.14), serum cholesterol (MD, -17.25; 95% CI, -42.79 to 8.29, = 0.19), serum phosphorus (MD, -0.41; 95% CI, -0.97 to 0.15, = 0.15), and serum calcium (MD, 0.16; 95% CI, -0.06 to 0.39, = 0.16) compared to a typical LPD in subjects with CKD. : A very-LPD supplemented with NFA showed a notably higher estimated glomerular filtration rate, decreased serum creatinine levels, lower blood urea nitrogen, and reduced parathyroid hormone levels; however, there were no significant differences observed in serum albumin, serum cholesterol, serum phosphorous, and serum calcium when compared to a standard LPD in individuals with CKD. Additional research is necessary to confirm these results.
我们进行了一项荟萃分析，以评估必需氨基酸的无氮替代物对慢性肾脏病（CKD）进展的影响。截至2024年11月进行的全面文献综述确定了15项研究，这些研究涉及1596名基线时患有CKD的参与者；其中，797人采用富含无氮类似物（NFA）的极低蛋白饮食（LPD），而799人遵循标准LPD。与CKD患者的标准LPD相比，采用NFA的极低蛋白饮食显示估计肾小球滤过率显著改善（MD，1.00；95%CI，0.35 - 1.64，P = 0.002），血清肌酐降低（MD， - 0.44；95%CI， - 0.75至 - 0.13，P = 0.006），血尿素氮降低（MD， - 35.34；95%CI， - 64.27至 - 6.42，P = 0.02），甲状旁腺激素水平降低（MD， - 1.25；95%CI， - 2.33至0.18，P = 0.02）。然而，与CKD受试者的典型LPD相比，含NFA的极低蛋白饮食在血清白蛋白（MD，0.08；95%CI， - 0.03至0.19，P = 0.14）、血清胆固醇（MD， - 17.25；95%CI， - 42.79至8.29，P = 0.19）、血清磷（MD， - 0.41；95%CI， - 0.97至0.15，P = 0.15）和血清钙（MD，0.16；95%CI， - 0.06至0.39，P = 0.16）方面没有显著差异。与CKD个体的标准LPD相比，补充NFA的极低蛋白饮食显示出明显更高的估计肾小球滤过率、降低的血清肌酐水平、更低的血尿素氮和降低的甲状旁腺激素水平；然而，在血清白蛋白、血清胆固醇、血清磷和血清钙方面没有观察到显著差异。需要进一步的研究来证实这些结果。
