Next Article in Journal
Analgesic Effect of Indian Gooseberry (Emblica officinalis Fruit) Extracts on Postoperative and Neuropathic Pain in Rats
Next Article in Special Issue
Comparative Study on Trace Element Excretions between Nonanuric and Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Previous Article in Journal
Disability, Physical Inactivity, and Impaired Health-Related Quality of Life Are Not Different in Metabolically Healthy vs. Unhealthy Obese Subjects
Previous Article in Special Issue
Cholecalciferol Additively Reduces Serum Parathyroid Hormone and Increases Vitamin D and Cathelicidin Levels in Paricalcitol-Treated Secondary Hyperparathyroid Hemodialysis Patients
Article Menu

Export Article

Open AccessArticle
Nutrients 2016, 8(12), 758; doi:10.3390/nu8120758

Patient Survival and Costs on Moderately Restricted Low-Protein Diets in Advanced CKD: Equivalent Survival at Lower Costs?

1
Department of Clinical and Biological Sciences, University of Torino, Torino 10100, Italy
2
Nephrologie, Centre Hospitalier Le Mans, Le Mans 72000, France
3
Obstetrics, Department of Surgery, Città Della Salute e Della Scienza, University of Torino, Torino 10100, Italy
4
SSD Clinical Nutrition, Department of Clinical and Biological Sciences, ASOU san Luigi, University of Torino, Torino 10100, Italy
5
SS Epidemiology, Department of Clinical and Biological Sciences, ASOU san Luigi, University of Torino, Torino 10100, Italy
*
Author to whom correspondence should be addressed.
Received: 8 August 2016 / Revised: 23 October 2016 / Accepted: 16 November 2016 / Published: 25 November 2016
(This article belongs to the Special Issue Nutrition and Chronic Kidney Disease)
View Full-Text   |   Download PDF [481 KB, uploaded 2 December 2016]   |  

Abstract

The indications for delaying the start of dialysis have revived interest in low-protein diets (LPDs). In this observational prospective study, we enrolled all patients with chronic kidney disease (CKD) who followed a moderately restricted LPD in 2007–2015 in a nephrology unit in Italy: 449 patients, 847 years of observation. At the start of the diet, the median glomerular filtration rate (GFR) was 20 mL/min, the median age was 70, the median Charlson Index was 7. Standardized mortality rates for the “on-diet” population were significantly lower than for patients on dialysis (United States Renal Data System (USRDS): 0.44 (0.36–0.54); Italian Dialysis Registry: 0.73 (0.59–0.88); French Dialysis Registry 0.70 (0.57–0.85)). Considering only the follow-up at low GFR (≤15 mL/min), survival remained significantly higher than in the USRDS, and was equivalent to the Italian and French registries, with an advantage in younger patients. Below the e-GFR of 15 mL/min, 50% of the patients reached a dialysis-free follow-up of ≥2 years; 25% have been dialysis-free for five years. Considering an average yearly cost of about 50,000 Euros for dialysis and 1200 Euros for the diet, and different hypotheses of “spared” dialysis years, treating 100 patients on a moderately restricted LPD would allow saving one to four million Euros. Therefore, our study suggests that in patients with advanced CKD, moderately restricted LPDs may allow prolonging dialysis-free follow-up with comparable survival to dialysis at a lower cost. View Full-Text
Keywords: low protein diet; dialysis start; mortality; standardized mortality ratio; registry; costs low protein diet; dialysis start; mortality; standardized mortality ratio; registry; costs
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Piccoli, G.B.; Nazha, M.; Capizzi, I.; Vigotti, F.N.; Mongilardi, E.; Bilocati, M.; Avagnina, P.; Versino, E. Patient Survival and Costs on Moderately Restricted Low-Protein Diets in Advanced CKD: Equivalent Survival at Lower Costs? Nutrients 2016, 8, 758.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top