About: Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?     Goto   Sponge   Distinct   Permalink

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  • Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological treatment, to motivated stage 4-5 chronic kidney disease (CKD) patients not having severe comorbid conditions; they probably represent 30-40% of the concerned population. A satisfactory adherence to such dietary prescription is observed in approximately 50% of the patients. While the results of the studies on the effects of this diet on the rate of progression of renal failure remain inconclusive, they are highly significant when initiation of dialysis is the primary outcome. The correction of uremic symptoms allows for initiation of dialysis treatment at a level of residual renal function lower than that usually recommended. Most of the CKD-associated complications of cardiovascular and metabolic origin, which hamper both lifespan and quality of life, are positively influenced by the diet. Lastly, with regular monitoring jointly assumed by physicians and dietitians, nutritional status is well preserved as confirmed by a very low mortality rate and by the absence of detrimental effect on the long-term outcome of patients once renal replacement therapy is initiated. On account of its feasibility, efficacy and safety, sVLPD deserves a place in the management of selected patients to safely delay the time needed for dialysis.
  • Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological treatment, to motivated stage 4-5 chronic kidney disease (CKD) patients not having severe comorbid conditions; they probably represent 30-40% of the concerned population. A satisfactory adherence to such dietary prescription is observed in approximately 50% of the patients. While the results of the studies on the effects of this diet on the rate of progression of renal failure remain inconclusive, they are highly significant when initiation of dialysis is the primary outcome. The correction of uremic symptoms allows for initiation of dialysis treatment at a level of residual renal function lower than that usually recommended. Most of the CKD-associated complications of cardiovascular and metabolic origin, which hamper both lifespan and quality of life, are positively influenced by the diet. Lastly, with regular monitoring jointly assumed by physicians and dietitians, nutritional status is well preserved as confirmed by a very low mortality rate and by the absence of detrimental effect on the long-term outcome of patients once renal replacement therapy is initiated. On account of its feasibility, efficacy and safety, sVLPD deserves a place in the management of selected patients to safely delay the time needed for dialysis. (en)
Title
  • Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?
  • Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients? (en)
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  • Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?
  • Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients? (en)
skos:notation
  • RIV/00023001:_____/13:00058702!RIV14-MZ0-00023001
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • N
http://linked.open...iv/cisloPeriodika
  • 6
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
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http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 70182
http://linked.open...ai/riv/idVysledku
  • RIV/00023001:_____/13:00058702
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • ketoacids; restriction; body composition; nutritional status; blood pressure control; cardiovascular risk factors; chronic kidney disease; chronic renal failure; low-protein diet (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [7EB80387916A]
http://linked.open...i/riv/nazevZdroje
  • Seminars in dialysis
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 26
http://linked.open...iv/tvurceVysledku
  • Teplan, Vladimír
  • Zakar, G.
  • Garneata, L.
  • Aparicio, M.
  • Bellizzi, V.
  • Chauveau, P.
  • Cupisti, A.
  • Ecder, T.
  • Fouque, D.
  • Lin, S.
  • Mitch, W.
  • Yu, X.
http://linked.open...ain/vavai/riv/wos
  • 000327030200014
issn
  • 0894-0959
number of pages
http://bibframe.org/vocab/doi
  • 10.1111/sdi.12132
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