Supplemented Very Low Protein Diet (sVLPD) in Patients with Advanced Chronic Renal Failure: Clinical and Economic Benefits
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Published:2023-08-13
Issue:16
Volume:15
Page:3568
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ISSN:2072-6643
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Container-title:Nutrients
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language:en
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Short-container-title:Nutrients
Author:
Cecchi Sofia1, Di Stante Silvio2ORCID, Belcastro Sara2, Bertuzzi Veronica2, Cardillo Assunta2, Diotallevi Laura2, Grabocka Xhensila2, Kulurianu Hrissa2, Martello Mauro2, Nastasi Valentina2, Paci Della Costanza Osmy2, Pizzolante Francesca2, Di Luca Marina2
Affiliation:
1. Department of Clinical and Molecular Science, Polytechnic University of Marche, 60121 Ancona, Italy 2. Department of Nephrology and Dialysis, Ospedale Santa Croce, Azienda Sanitaria Territoriale n 1, Pesaro-Urbino, 61032 Fano, Italy
Abstract
The supplemented very low-protein diet (sVLPD) has proven effective in slowing the progression of stage 5 chronic renal failure and postponing the start of the dialysis treatment. However, sVLPD could expose the patient to the risk of malnutrition. This diet is also difficult to implement due to the required intake of large number of keto-analogue/amino acid tablets. In our Center, the Department of Nephrology and Dialysis of Azienda Sanitaria Territoriale n 1, Pesaro-Urbino, of Italy, respecting the guidelines of normal clinical practice, we prescribed sVLPD (0.3 g/prot/day) supplemented with only essential amino acids without the use of ketoanalogues in stage 5 patients and verified its efficacy, safety and clinical and economic effects. Over the 24 months period of observation the progression of chronic kidney disease (CKD) slowed down (mean eGFR 11.6 ± 3.3 vs. 9.3 ± 2.7 mL/min/1.73 m2, p < 0.001) and the start of the dialysis treatment (adjusted HR = 0.361, CI 0.200–0.650, p = 0.001) was delayed without evidence of malnutrition, in compliant vs. non-compliant patients. This led to a substantial cost reduction for the National Health System. This non-interventional longitudinal observational study is part of standard clinical practice and suggests that VLPD supplemented with essential amino acids could be extensively used to reduce the incidence of dialysis treatments, with a favorable economic impact on the NHS.
Funder
Hemodialysed National Association
Subject
Food Science,Nutrition and Dietetics
Reference56 articles.
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