Supplemented Very Low Protein Diet and the Progression of Chronic Kidney Disease

NCT ID: NCT02031224

Last Updated: 2017-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-03-31

Study Completion Date

2014-08-31

Brief Summary

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This is a prospective single center randomized controlled trial with a total duration of 18 months aiming to evaluate the effectiveness and the safety of a very low protein diet supplemented with ketoanalogues of essential aminoacids in reducing the progression of chronic kidney disease (CKD) in patients with advanced CKD.

Detailed Description

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All eligible patients who will give informed consent will be screened. Those meeting the selection criteria will be enrolled and will enter a 3-month run-in phase during which a conventional LPD will be prescribed in all patients.

At the end of this phase, the subjects still fulfilling all the selection criteria will be randomized in a 1:1 ratio to receive the KD or to continue the conventional LPD for a total duration of 15 months.

Nineteen blood and urine samplings are scheduled for each patient, to be drawn monthly. The laboratory reports include the nitrogen compounds, calcium-phosphorus metabolism parameters, acid-base balance, biochemical nutritional markers, serum C-reactive protein, hemoglobin, blood cell count, and biochemical safety parameters (sodium, potassium, liver enzymes, and bilirubin).

The anthropometric measurements and subjective global assessment will be evaluated at enrolment, at randomization, and every 3 months thereafter.

The compliance with the prescribed diet (protein and energy intake) will be assessed monthly during the run-in phase, weekly for the first month after randomization, every 4 weeks during the next 6 months, and every 3 months thereafter.

The blood pressure levels, drugs required for the therapy of hypertension, acidosis and mineral metabolism disorders, and occurrence of adverse events will be recorded monthly.

Conditions

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Chronic Kidney Disease

Keywords

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Chronic Kidney Disease Restricted protein diets Nutritional status

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Keto-diet (KD)

Patients in the intervention arm (KD group) will receive a vegetarian very low protein diet (0.3 g proteins/kg ideal body weight per day) supplemented with ketoanalogues of essential amino acids (Ketosteril®, Fresenius Kabi, Bad Homburg, Germany), 1 capsule for every 5 kg of ideal dry body weight per day.

Group Type EXPERIMENTAL

Very low protein diet supplemented with Ketosteril

Intervention Type DIETARY_SUPPLEMENT

Low Protein Diet group (LPD)

The patients in the control arm (LPD group) will continue their conventional low protein diet, with 0.6 g/kg per day (including high biological value proteins).

The total recommended energy intake is of 30 kcal/kg of ideal dry body weight per day in both arms.

Group Type ACTIVE_COMPARATOR

Conventional low protein diet

Intervention Type BEHAVIORAL

Interventions

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Conventional low protein diet

Intervention Type BEHAVIORAL

Very low protein diet supplemented with Ketosteril

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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LPD Hypoproteic diet SVLPD, Keto-diet

Eligibility Criteria

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Inclusion Criteria

* adult non-diabetic patients
* stage 4-5 CKD not on dialysis (estimated glomerular filtration by Modification of Diet in Renal Disease formula \< 30 mL/min per year
* stable renal function at least 12 weeks before enrollment
* well-controlled arterial blood pressure
* proteinuria less than 1 g/g urinary creatinine
* good nutritional status
* declared and anticipated good compliance with the prescribed diet

Exclusion Criteria

* poorly controlled arterial blood pressure (≥145/85 mm Hg)
* relevant comorbid conditions (diabetes mellitus, heart failure, active hepatic disease, digestive diseases with malabsorption, inflammation/anti-inflammatory therapy)
* uremic complications (pericarditis, polyneuropathy)
* feeding inability (anorexia, nausea)
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dr Carol Davila Teaching Hospital of Nephrology Bucharest

UNKNOWN

Sponsor Role collaborator

Anemia Working Group Romania

OTHER

Sponsor Role lead

Responsible Party

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Liliana Garneata

Assistant Professor of Nephrology, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gabriel Mircescu, Prof

Role: STUDY_CHAIR

Carol Davila University of Medicine and Pharmacy

Locations

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"Dr Carol Davila" Teaching Hospital of Nephrology

Bucharest, , Romania

Site Status

Countries

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Romania

References

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Mircescu G, Garneata L, Stancu SH, Capusa C. Effects of a supplemented hypoproteic diet in chronic kidney disease. J Ren Nutr. 2007 May;17(3):179-88. doi: 10.1053/j.jrn.2006.12.012.

Reference Type RESULT
PMID: 17462550 (View on PubMed)

Hahn D, Hodson EM, Fouque D. Low protein diets for non-diabetic adults with chronic kidney disease. Cochrane Database Syst Rev. 2020 Oct 29;10(10):CD001892. doi: 10.1002/14651858.CD001892.pub5.

Reference Type DERIVED
PMID: 33118160 (View on PubMed)

Other Identifiers

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AWG13/2007

Identifier Type: -

Identifier Source: org_study_id