• MeSH
• Internal Medicine MeSH
• Publication type
• Textbook MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• vnitřní lékařství
• NML Publication type
• kolektivní monografie

• MeSH
• Internal Medicine * MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• vnitřní lékařství
• NML Publication type
• kolektivní monografie
• učebnice vysokých škol

• MeSH
• Internal Medicine MeSH
• Publication type
• Handbook MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• vnitřní lékařství
• NML Publication type
• učebnice vysokých škol
• kolektivní monografie

BACKGROUND: While a low-protein diet may preserve residual renal function (RRF) in chronic kidney disease (CKD) patients before the start of dialysis, a high-protein intake is usually recommended in dialysis patients to prevent protein-energy wasting. Keto acids, which were often recommended to pre-dialysis CKD patients treated with a low-protein diet, had also been reported to be associated with both RRF and nutrition maintenance. We conducted a randomized trial to test whether a low-protein diet with or without keto acids would be safe and associated with a preserved RRF during peritoneal dialysis (PD). METHODS: To assess the safety of low protein, we first conducted a nitrogen balance study in 34 incident PD patients randomized to receive in-centre diets containing 1.2, 0.9 or 0.6 g of protein/kg ideal body weight (IBW)/day for 10 days. Second, 60 stable PD patients [RRF 4.04 +/- 2.30 ml/ min/1.73 m(2), urine output 1226 +/- 449 ml/day, aged 53.6 +/- 12.8 years, PD duration 8.8 (1.5-17.8) months] were randomized to receive either a low- (LP: 0.6-0.8 g/kg IBW/day), keto acid-supplemented low- (sLP: 0.6-0.8 g/kg IBW/day with 0.12 g/kg IBW/day of keto acids) or high-protein (HP: 1.0-1.2 g/kg IBW/day) diet. The groups were followed for 1 year and RRF as well as nutritional status was evaluated serially. RESULTS: A neutral or positive nitrogen balance was achieved in all three groups. RRF remained stable in group sLP (3.84 +/- 2.17 to 3.39 +/- 3.23 ml/min/1.73 m(2), P = ns) while it decreased in group LP (4.02 +/- 2.49 to 2.29 +/- 1.72 ml/min/1.73 m(2), P < 0.05) and HP (4.25 +/- 2.34 to 2.55 +/- 2.29 ml/min/1.73 m(2), P < 0.05). There was no change from baseline on nutritional status in any of the groups during follow-up. CONCLUSIONS: A diet containing 0.6-0.8 g of protein/kg IBW/day is safe and, when combined with keto acids, is associated with an improved preservation of RRF in relatively new PD patients without significant malnutrition or inflammation.

• MeSH
• Kidney Failure, Chronic diet therapy   metabolism   MeSH
• Dietary Proteins administration & dosage   MeSH
• Adult MeSH
• Nitrogen metabolism   MeSH
• Financing, Organized MeSH
• Keto Acids metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Peritoneal Dialysis methods   MeSH
• Dietary Supplements MeSH
• Prospective Studies MeSH
• Randomized Controlled Trials as Topic MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Tissue Distribution MeSH
• Kidney Function Tests MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

• MeSH
• Reference Books, Medical MeSH
• Internal Medicine * MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• vnitřní lékařství
• NML Publication type
• kolektivní monografie

• MeSH
• Peritoneal Dialysis complications   MeSH
• Cell Membrane Permeability MeSH
• Nutrition Disorders MeSH
• Risk Factors MeSH
• Serum Albumin analysis   MeSH
• Publication type
• Congress MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• nefrologie
• urologie

• MeSH
• Peritoneal Dialysis MeSH
• Publication type
• Periodical MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• nefrologie