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Open AccessArticle

Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide Cohort Study

1
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
2
Department of Cardiology, Chang Gung Memorial Hospital, Chiayi branch, Chiayi 61363, Taiwan
3
Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan 33341, Taiwan
4
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33341, Taiwan
*
Author to whom correspondence should be addressed.
Chieh-Li Yen and Kun-Hua Tu contributed equally to this manuscript.
Nutrients 2018, 10(8), 1035; https://doi.org/10.3390/nu10081035
Received: 20 July 2018 / Revised: 3 August 2018 / Accepted: 6 August 2018 / Published: 8 August 2018
Background: A beneficial effect of a ketoanalogue-supplemented low-protein diet (sLPD) in postponing dialysis has been demonstrated in numerous previous studies. However, evidence regarding its effect on long-term survival is limited. Our study assessed the long-term outcomes of patients on an sLPD after commencing dialysis. Methods: This retrospective study examined patients with new-onset end-stage renal disease with permanent dialysis between 2001 and 2013, extracted from Taiwan’s National Health Insurance Research Database. Patients who received more than 3 months of sLPD treatment in the year preceding the start of dialysis were extracted. The outcomes studied were all-cause mortality, infection rate, and major cardiac and cerebrovascular events (MACCEs). Results: After propensity score matching, the sLPD group (n = 2607) showed a lower risk of all-cause mortality (23.1% vs. 27.6%, hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.70–0.84), MACCEs (19.2% vs. 21.5%, HR 0.86, 95% CI 0.78–0.94), and infection-related death (9.9% vs. 12.5%, HR 0.76, 95% CI 0.67–0.87) than the non-sLPD group did. Conclusion: We found that sLPD treatment might be safe without long-term negative consequences after dialysis treatment. View Full-Text
Keywords: chronic kidney disease; ketoacids; low-protein diet; survival; nutrition; adverse events chronic kidney disease; ketoacids; low-protein diet; survival; nutrition; adverse events
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Yen, C.-L.; Tu, K.-H.; Lin, M.-S.; Chang, S.-W.; Fan, P.-C.; Hsiao, C.-C.; Chen, C.-Y.; Hsu, H.-H.; Tian, Y.-C.; Chang, C.-H. Does a Supplemental Low-Protein Diet Decrease Mortality and Adverse Events After Commencing Dialysis? A Nationwide Cohort Study. Nutrients 2018, 10, 1035.

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