The role of once-weekly online hemodiafiltration with low protein diet for initiation of renal replacement therapy: A case series

2021 ◽  
pp. 039139882110498
Author(s):  
Kullaya Takkavatakarn ◽  
Piyawan Kittiskulnam ◽  
Khajohn Tiranathanagul ◽  
Pisut Katavetin ◽  
Niramon Wongyai ◽  
...  
Keyword(s):  
Urine Volume ◽  
Case Series ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Incremental Hemodialysis ◽  
Clinical Benefits ◽  
The Mean ◽  
The University

Incremental hemodialysis (HD) has become an exciting approach according to the recognition of the importance of preserving residual kidney function (RKF). However, not all incident HD patients are suitable for this approach, particularly once-weekly HD. This is the first study which reported the effectiveness of once-weekly online-hemodiafiltration (OL-HDF) plus low protein diet (LPD) in incident HD patients. All stage 5 CKD patients who had chosen HD as their treatment modality at the HD center of King Chulalongkorn Memorial Hospital, Bangkok, Thailand, with RKF ⩾ 3 mL/min calculated by renal clearance of urea and urine output ⩾ 800 mL/day, started the treatment with once-weekly OL-HDF. Dietitians advised patients to consume LPD (0.6–0.8 g/kg/day) on non-dialysis days and a regular protein diet on the dialysis day (1.2 g/kg/day). Eleven incident HD patients were enrolled in the study. The mean RKF and urine volume at baseline were 4.56 ± 2.21 mL/min and 2,019.54 ± 743.73 mL/day, respectively. After 6 and 12 months of follow-up, the mean RKF of the patients who remained in the once-weekly OL-HDF protocol were 3.82 ± 1.68 mL/min and 3.28 ± 0.95 mL/min, respectively. The median duration of once-weekly OL-HDF before transitioning to twice- or thrice-weekly OL-HDF was 7 months (3–24 months). The most common indication for stepping prescription was too low RKF. We reported that dialysis initiation in the university-based center with once-weekly OL-HDF in carefully selected incident HD patients combined with LPD under serial monitoring is practical. Further studies on the clinical benefits of once-weekly OL-HDF are still required.

scholarly journals The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 957 ◽  
Author(s):  
Albert Li ◽  
Hsiang-Yen Lee ◽  
Yen-Chung Lin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Randomized Control ◽  
Very Low Protein Diet ◽  
Restricted Protein Diet

The effects of ketoanalogues (KA) on chronic kidney disease (CKD) deterioration have not yet been fully confirmed. To strengthen the evidence of the role of KA in CKD, PubMed and Embase were searched for studies published through February 2019. Effect sizes from ten randomized control trials (RCTs) and two non-RCTs comprising a total of 951 patients were pooled and analyzed. A restricted protein diet supplemented with ketoanalogues (RPKA) was found to significantly delay the progression of CKD (p = 0.008), particularly in patients with an estimated glomerular filtration rate (eGFR) > 18 mL/min/1.73 m2 (p < 0.0001). No significant change in eGFR was found when comparing a very-low-protein diet and a low-protein diet (p = 0.10). In addition, compared with the placebo, RPKA did not cause malnutrition (albumin: p = 0.56; cholesterol: p = 0.50). Moreover, RPKA significantly decreased phosphorous levels (p = 0.001), increased calcium levels (p = 0.04), and decreased parathyroid hormone (PTH) levels (p = 0.05) in patients with eGFR < 18 mL/min/1.73 m2. In conclusion, RPKA could slow down the progression of CKD in patients with eGFR > 18 mL/min/1.73 m2 without causing malnutrition and reverse CKD-MBD in patients with eGFR < 18 mL/min/1.73 m2.

scholarly journals Liver GCN2 controls hepatic FGF21 secretion and modulates whole body postprandial oxidation profile under a low-protein diet

2019 ◽  
Vol 317 (6) ◽  
pp. E1015-E1021 ◽  
Author(s):  
Tristan Chalvon-Demersay ◽  
Joanna Moro ◽  
Patrick C. Even ◽  
Catherine Chaumontet ◽  
Daniel Tomé ◽  
...  
Keyword(s):  
High Protein Diet ◽  
High Protein ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Whole Body ◽  
Low Protein ◽  
The One ◽  
High Level ◽  
High Protein Diets

General control nonderepressible 2 (GCN2) is a kinase that detects amino acid deficiency and is involved in the control of protein synthesis and energy metabolism. However, the role of hepatic GCN2 in the metabolic adaptations in response to the modulation of dietary protein has been seldom studied. Wild-type (WT) and liver GCN2-deficient (KO) mice were fed either a normo-protein diet, a low-protein diet, or a high-protein diet for 3 wk. During this period, body weight, food intake, and metabolic parameters were followed. In mice fed normo- and high-protein diets, GCN2 pathway in the liver is not activated in WT mice, leading to a similar metabolic profile with the one of KO mice. On the contrary, a low-protein diet activates GCN2 in WT mice, inducing FGF21 secretion. In turn, FGF21 maintains a high level of lipid oxidation, leading to a different postprandial oxidation profile compared with KO mice. Hepatic GCN2 controls FGF21 secretion under a low-protein diet and modulates a whole body postprandial oxidation profile.

scholarly journals The role of maternal low protein diet on neural stem cells and neurogenesis in the offspring brain?

2014 ◽  
Author(s):  
Chris J Airey ◽  
Phoebe J Smith ◽  
Joanna M Gould ◽  
Stephanie J Marfy-Smith ◽  
Tom P Fleming ◽  
...  
Keyword(s):  
Stem Cells ◽  
Neural Stem Cells ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

scholarly journals The Role of Low Protein Diet (LPD) in the Treatment of Chronic Kidney Disease (CKD)

2003 ◽  
Vol 51 (6) ◽  
pp. 928-932 ◽  
Author(s):  
Tatsuo SHIIGAI ◽  
Yoshitaka MAEDA ◽  
Takahiko KOBAYASHI ◽  
Takehito TANASE ◽  
Kimie KOBAYASHI
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

Variability of the Methionine Loading Test: No Effect of a Low Protein Diet

1996 ◽  
Vol 33 (6) ◽  
pp. 551-554 ◽  
Author(s):  
Martin den Heijer ◽  
Gerard M J Bos ◽  
Ingeborg A Brouwer ◽  
Wim B J Gerrits ◽  
Henk J Blom
Keyword(s):  
Protein Diet ◽  
Low Protein Diet ◽  
Vitamin B ◽  
Standard Diet ◽  
Loading Test ◽  
Homocysteine Concentration ◽  
Low Protein ◽  
Transsulfuration Pathway ◽  
The Mean ◽  
Methionine Loading Test

The methionine loading test is used for the diagnosis of impaired methionine/homocysteine metabolism, in particular the transsulfuration pathway. Usually this test is performed on a low protein diet to control the intake of methionine. However, this is inconvenient and relatively expensive. In this study we compared the effects of a low protein diet and a standard diet on methionine loading test in 28 subjects (crossover design). The mean difference in homocysteine concentration after methionine loading between the two diets was 1.3 [confidence interval (CI) 95%-1.0–3.6]μmol/L which demonstrates that a special low protein diet is not essential in the performance of the methionine loading test. We also observed that 3 weeks after the first methionine loading test, fasting serum concentration of folate was higher and vitamin B12 concentration was lower.

scholarly journals Vitamin A and protein interrelationships in the milk-fed lamb

1970 ◽  
Vol 24 (1) ◽  
pp. 11-22 ◽  
Author(s):  
O. Faruque ◽  
D. M. Walker
Keyword(s):  
Vitamin A ◽  
Protein Concentration ◽  
Live Weight ◽  
High Protein Diet ◽  
Retinyl Palmitate ◽  
High Protein ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
The Mean

1. The mean liver retinol reserve (retinal + retinyl esters, expressed as retinol) of six newborn lambs was 21±8 μg. The mean value for ten suckled lambs, aged 5–7 days, was 2655±472 μg retinol per liver.2. Three unsuckled lambs were fed ad lib. from birth for 28 days on a high-protein diet, based on lard and skim milk, without supplementary vitamin A. The diet provided sufficient vitamin A for normal growth, but insufficient to permit substantial liver reserves (43±8 μg retinol per liver).3. Thirty-six suckled lambs aged 5–7 days were given either a low-or a high-protein diet for 21 days, with or without graded levels of retinyl acetate or βcarotene. There were no significant differences in the live-weight gain or in liver retinol reserves between the low-and highprotein dietary treatments, or between the supplemented and unsupplemented groups.4. Twelve lambs were pair-fed on either a low-or a high-protein diet from birth for 21 days. Six lambs that were given a large supplement of retinyl palmitate on the 1st day of life had stored significantly less retinol in the liver at 21 days (P > 0.01) than six lambs given a somewhat smaller total amount of retinyl palmitate in small daily doses. Lambs given the high-protein diet had significantly greater liver retinol reserves (P > 0.01) than lambs given the low-protein diet, with both methods of supplementation.5. Twelve lambs were pair-fed from birth on a high-protein diet for 2 or 6 days. Lambs that were given retinyl palmitate dissolved in either a low-or a high-protein diet on the 1st day of life had significantly lower liver retinol reserves some 24 h later (P > 0.01) than lambs given similar treatments on the 5th day of life. Liver retinol reserves were positively correlated with the protein concentration of the diet at the time of supplementation.6. Eighteen lambs were pair-fed from birth with either a low- or a high-protein diet. Six pairs were given retinyl palmitate daily and three pairs were given the supplement 48 h before slaughter. The source of protein was casein. Eight out of nine lambs given the low-protein diet would have died had they not been slaughtered at between 8 and 11 days of age. The time of supplementation had no significant effect on liver retinol reserves, which were very low, regardless of the dietary protein concentration. Lambs given the high-protein diet retained a significantly greater proportion (P > 0.05) of the dietary retinyl palmitate than lambs given the low-protein diet.

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