Abstract: SA-PO800
Low-Protein Diet for Patients Older Than 70 Years with CKD due to Benign Nephrosclerosis Is Effective in Suppressing Its Progression Without Causing Sarcopenia and Frailty
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Inoue, Yoshihiko, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Kawata, Naoto, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Miyazaki, Tomoaki, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Omiya, Shinya, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Inui, Kiyoko, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Yoshimura, Ashio, Shinyokohama Daiichi Clinic, Yokohama, Japan
- Koiwa, Fumihiko, Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
Background
Restriction of protein intake delays or stops the progression of CKD. However, the effect of low-protein diet (LPD) in the elderly CKD patients is not well understood because of risk for malnutrition and other concerns. We studied the effect of LPD on them.
Methods
Patients with CKD stage 3-4 due to benign nephrosclerosis (BNS) were studied. All of them were 70 years old or older. Nutritional guidance of energy 30-35 Kcal/kgBW/day, protein intake 0.6-0.8 g/kgBW/day, salt intake 6g/day was given to patients. Protein intake was evaluated using the Maroni’s formula by 24-hour urine sample. We studied for 3 years after the start of the LPD and also evaluated renal function and nutritional status.
Results
50 patients were included in this study. Majority of patients were male (64%). The average age of patients is 75.5±5.39 years. 33 (LPD group) out of 50 patients were able to achieve less than 0.8g/kgBW/day (average: 0.60±0.10g/kgBW/day) of dietary protein in the evaluation of the Maroni’s formula. 87.8% patients of the LPD group used low protein rice as a special low protein food. The LPD group showed significant improvement in eGFR, salt intake compared with the non-LPD group (n=17). The LPD group also did not have body weight loss, trouble climbing stairs, poor balance, weakness and not decrease walking speed, hemoglobin, albumin, T-cho and BMI (table 1). Four patients in the LPD group decreased eGFR. These four patients had significantly more amount of urine protein since the start of the study.
Conclusion
Even in the elderly, application of LPD is possible and effective in CKD stage 3-4 patients due to BNS. LPD in the elderly does not cause sarcopenia/frailty if it contains enough energy. Use of special protein-restriction foods is important in success of continuation of low protein diet.
Table 1
| Non-LPD group (>0.8g/kgBW/day, n=17) | LPD group (< 0.8kg/kgBW/day, n=33) | |||||
| Baseline | End of the study (3-year) | P | Baseline | End of the study (3-year) | P | |
| Protein intake (g/kgBW/day) | 1.42±0.12 | 1.03±0.13 | <0.05 | 1.35±0.10 | 0.60±0.10 | <0.05 |
| Salt intake (g/day) | 10.2±1.8 | 7.4±1.7 | <0.05 | 10.0±2.9 | 5.6±1.7 | <0.05 |
| BMI | 24.2±2.1 | 23.8±1.9 | N.S. | 21.4±2.3 | 21.5±2.1 | N.S. |
| Hb (g/dl) | 12.4±1.4 | 12.0±1.7 | N.S. | 11.9±1.4 | 12.1±1.4 | N.S. |
| Albumin (g/dl) | 4.1±0.3 | 4.1±0.3 | N.S. | 4.0±0.4 | 4.0±0.4 | N.S. |
| T-cho (mg/dl) | 181.1±31.0 | 176.8±44.5 | N.S. | 193.4±27.3 | 189.1±18.1 | N.S. |
| eGFR (ml/min/1.73m2) | 30.34±13.85 | 24.78±12.64 | <0.05 | 28.49±10.91 | 30.11±12.58 | <0.05 |
| Usage of low protein rice (%) | 23.5 | 87.8 | ||||