Background and Objective

1. Table 1. Demographic characteristics of study subjects under maintenance hemodialysis (HD) or peritoneal dialysis (PD), before (A) and after (B) matching with age, gender, and co-morbid diabetes mellitus (DM). Note: HD, hemodialysis; PD, peritoneal dialysis. Comparison of the effects between keto-/amino acid supplemented low protein diet and non-supplemented low protein diet in patients with stage Ⅴ chronic kidney diseaseTze-Wah Kao1,2, Chia-Te Liao2, Chi-Ting Su2, Cheng-Lin Lang2, Kuan-Yu Hung2,Jenq-Wen Huang2, Pau-Chung Chen1, Kwan-Dun Wu21Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health;2Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine Dietary protein restriction has been proved to be beneficial to renal failure patients. This study aimed to compare the effects between keto-/amino acid supplemented low protein diet (SLPD) and non-supplemented low protein diet (LPD) in patients with stage Ⅴ chronic kidney disease (CKD). Table 1. Estimates Measured by the Generalized Estimated Equations for Variables Background and Objective Results and Discussion Materials and Methods This study was a randomized clinical trial. Eligible patients were allocated into 2 groups. Group 1 received SLPD while Group 2 received LPD. Baseline characteristics between the two groups were compared with Wilcoxon signed ranks test. Generalized estimating equations were used to compare renal function, hemodynamics, nutritional status, biochemical data, body composition, bone mineral density (BMD), and health-related quality of life (HRQOL) between groups after 6 months of treatment. Results Forty three patients (18 male) joined the study. No statistical difference was found between the two groups in baseline characteristics and laboratory data. Glomerular filtration rate of all patients decreased with time slowly (p<0.0001), but Group 1 patients showed slower reduction than Group 2 patients (p<0.0001). Compared to Group 2 patients, Group 1 patients had lower systolic blood pressure (p=0.0312), higher serum albumin level (p<0.0001), less 24-hour urinary protein (p=0.0314), and higher HDL levels (p<0.0001). Uric acid level (p<0.0001) and intact parathyroid hormone level (p=0.0437) were also higher in Group 1 patients (Table 1). Both body fat percentage (p=0.016) and waist-to-hip ratio (p=0.039) decreased with time in Group 1 patients but increased in Group 2 (Table 2). Neither BMD nor HRQOL was found to be statistically different between the two groups. Table 2. Body Composition of Patients Note：GFR, glomerular filtration rate; SBP, systolic blood pressure; Alb, albumin; UA, uric acid; iPTH, intact parathyroid hormone; UP, urinary protein loss per day. Conclusion SLPD preserves renal function better and exerts more favorable effects on blood pressure, nutrition, lipid metabolism and urinary protein excretion than LPD. Note: Data are presented in Mean ± SD. Corresponding author’s e-mail: pchen@ntu.edu.tw; First author’s e-mail: twkao2@ntuh.gov.tw OMIH