A Ikizler1,H Zhang2
1Division of Nephrology, Nashville, USA, 2Department of Nephropathy, Changsha, China
Authors: Alp Ikizler1 and Hao Zhang2 for the CKDOD China Study Group
Aim: Analyze dietary protein characteristics and compliance with dietary prescriptions in Chinese CKD patients in clinical practice.
Background: Protein-restriction with and without ketoanalogue (KA) supplementation aims to attenuate time to dialysis by reducing nitrogen load and uremic symptoms. The Chronic Kidney Disease Observational Database (CKDOD) clinical registry investigates the effects of these practices on kidney disease progression and the modifying factors in a real-world setting.
Methods: CKDOD is an observational, multi-center clinical registry across 5 Asian countries (India, China, Thailand, Malaysia, Taiwan). This analysis examines baseline demographics, renal function and compliance to protein restricted diets stratified by KA supplementation in follow up visits in the cohort from China (n = 692).
Results: Patients who were prescribed KA had a significantly lower mean BMI (23.2 ± 3.9 kg/m²) compared to non-KA patients (24.4 ± 3.9 kg/m²). The estimated glomerular filtration rate (eGFR) was significantly lower in KA-patients (29.5 ± 21.1 mL/min/1.73 m² vs 49.9 ± 29.1 mL/min/1.73 m²). However, both groups were mainly prescribed the same protein diet of 0.6–1.0 g protein/kg bodyweight/day (71.4% of KA-patients, 75.9% of non-KA patients). Compliance to protein-restricted diets, rated on a 5-point-scale by the investigators, was similar at baseline, but differed significantly 6 and 12 months after enrolment: based on the assessments, more KA-patients showed a higher compliance.
Conclusions: In CKDOD, Chinese patients on KA had worse nutrition status at baseline and had better compliance to protein-restricted diets.
Dr. Ikizler is currently the Director of Division of Nephrology and Hypertension, Professor of Medicine and Catherine McLaughlin Hakim Chair in Vascular Biology at the Vanderbilt University School of Medicine in Nashville, Tennessee. He is a member of American Society of Clinical Investigation (ASCI), Association of American Physicians (AAP), and FASEB Board of Directors. Dr. Ikizler’s clinical and research interests and expertise are focused on the care of the patients with chronic kidney disease, end-stage kidney disease on maintenance dialysis and acute kidney injury. He has research and clinical interest in nutritional and metabolic aspects of acute and chronic disease.