Keto Analogues in Patients with Chronic Kidney Disease with or Without Kidney Transplantation

Nutrients. 2024 Nov 22;16(23):4001. doi: 10.3390/nu16234001.

Abstract

Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use of this method in patients with chronic kidney disease and a kidney transplantation. Materials: This was a retrospective monocentric study conducted by the transplant nephrology department in Martin, in which patients with chronic kidney disease, with or without kidney transplant therapy, who received a low-protein diet and supplementation with keto analogues were included (n = 59). The changes in their glomerular filtration rate, proteinemia, calcaemia, weight, and glycaemia and the side effects associated with a low-protein diet and keto analogue use were studied in the patients with chronic kidney disease with or without kidney transplantation. Results: The kidney transplant recipients had a significantly more advanced stage of chronic kidney disease (p = 0.0001) than the non-transplanted patients at the time of the prescription of the keto analogues (p = 0.0001). Furthermore, the kidney transplant recipients had a significantly longer follow-up period (p = 0.0001), with a difference of 27 months within subgroups. During the observed period, we recorded a decrease in glomerular filtration, but without statistical significance. In our group, we did not confirm a significant occurrence of adverse effects associated with a low-protein diet and keto analogues. Conclusion: Keto analogues reduce the progression of chronic kidney disease and stabilise glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with keto analogues is effective and safe for kidney transplant recipients after kidney transplantation.

Keywords: keto analogues; kidney transplant recipients; low-protein diet; side effects.

MeSH terms

  • Adult
  • Aged
  • Diet, Protein-Restricted* / methods
  • Dietary Supplements
  • Disease Progression
  • Female
  • Glomerular Filtration Rate* / drug effects
  • Humans
  • Keto Acids / administration & dosage
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Keto Acids

Grants and funding

Funded by the EU Next Generation EU through the Recovery and Resilience Plan for Slovakia under the project Number: 09I03-03-V04-00211.