Review: a low protein diet delays end stage renal disease or death in chronic kidney disease

Background: The number of patients with End Stage Renal Disease (ESRD) is growing annually around the world. Provision of renal replacement therapy in the form of dialysis and transplant is relatively expensive. Recent studies have shown no survival benefit of early initiation of dialysis. Given recent outcome data of the timing of dialysis treatment and the expenses and logistics of hemodialysis procedure have stimulated research on alternative strategies. The aim of this study is to introduce another type of renal replacement therapy for selective patients with advanced chronic kidney disease (CKD).Methods: In a case series we used a so-called “dialysis free protocol” consisting of a low protein diet, uremic toxin adsorbents, and prebiotics for selective ESRD patients who had dialysis access constraints or did not agree placement of hemodialysis vascular access or peritoneal dialysis catheter. Findings: clinical and biochemical results of this study showed that these patients were not deteriorating during the study period and Blood Urea Nitrogen (Bun) & serum creatinin levels were not elevated in these months. Participating patients were relatively well throughout the study without signs of florid uremia and without a need for emergent or urgent dialysis. Conclusion: We conclude that our proposed dialysis free protocol reduces the need for dialysis treatment at least transiently. Whether this protocol can reduce the need for dialysis treatment requires additional studies. Key words: End Stage Renal Disease, Low Protein Diet, Prebiotics, Activated Charcoal

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Faculty Opinions recommendation of Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end-stage renal disease: a randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1091047.552935 ◽

2007 ◽

Author(s):

Rajiv Agarwal

Keyword(s):

Chronic Kidney Disease ◽

Randomized Controlled Trial ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Controlled Trial ◽

Advanced Chronic Kidney Disease ◽

Randomized Controlled ◽

Stage Renal Disease ◽

End Stage

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Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010326 ◽

2021 ◽

Vol 18 (1) ◽

pp. 326

Author(s):

Chih-Chien Chiu ◽

Ya-Chieh Chang ◽

Ren-Yeong Huang ◽

Jenq-Shyong Chan ◽

Chi-Hsiang Chung ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Root Canal ◽

Dialysis Patients ◽

Root Canal Therapy ◽

Risk Of Death ◽

Stage Renal Disease ◽

End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

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