Abstract: TH-PO440
Real-Life Data from a Ketogenic Metabolic Therapy Program for Autosomal-Dominant Polycystic Kidney Disease Suggests Significant Benefits to Participants
Session Information
- Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1201 Genetic Diseases of the Kidneys: Cystic
Authors
- Muensterman, Emily Grace, Santa Barbara Nutrients, Inc., Santa Barbara, California, United States
- Welsh, Kelly L., Kidney Nutrition Institute, Titusville, Florida, United States
- Bruen, Diana, Santa Barbara Nutrients, Inc., Santa Barbara, California, United States
- Torres, Jacob A., Santa Barbara Nutrients, Inc., Santa Barbara, California, United States
- Weimbs, Thomas, Santa Barbara Nutrients, Inc., Santa Barbara, California, United States
- Saville, Jessianna, Kidney Nutrition Institute, Titusville, Florida, United States
Background
ADPKD, the most common genetic form of chronic kidney disease, lacks pharmacological treatments to halt or reverse its progression. Recent studies indicate that nutrition and lifestyle factors, such as renal microcrystals (calcium oxalate/phosphate/uric acid) and metabolic issues (persistent hyperglycemia/insulin resistance), contribute to ADPKD progression. Dietary interventions aiming to reduce renal microcrystals through citrate supplementation and urine alkalization, and to improve metabolism via ketosis or beta-hydroxybutyrate (BHB) supplementation, have shown promise in animal models. Recent human clinical studies also support the potential benefits of these interventions.
Methods
The Ren.Nu program, developed in 2021 by renal dietitians and PKD-focused scientists, helps patients adopt a plant-focused, kidney-safe, ketogenic lifestyle to improve metabolic health and reduce renal microcrystal burden. It uses KetoCitra®, a medical food with exogenous BHB, citrate, minerals, and alkaline base. Nearly 200 ADPKD patients have completed the personalized medical nutrition therapy group program. The first year of development focused on methodology refinement, and since 2022, clinical and quality of life (QOL) data have been collected. This is not a formal clinical trial but an assessment of a real-life dietary program.
Results
Analysis of outcomes for 103 participants from baseline to program completion revealed significant improvements. Participants adhered well to the diet and lifestyle changes, evidenced by consistently elevated blood BHB levels and reduction in fat weight loss. There was a 6.3% increase in the estimated glomerular filtration rate (eGFR) from 58.4 to 61.6 mL/min/1.73m2 (P<0.001). The program reduced kidney pain, headaches, and hypertensive medication use. Biomarkers (total-, HDL-, LDL-cholesterol, triglycerides, potassium, phosphorus, bicarbonate) remained stable, indicating safety.
Conclusion
Our evaluation and ongoing clinical experience with the Ren.Nu program indicates that its dietary and lifestyle interventions, combined with the medical food, KetoCitra®, are feasible and safe. Several ongoing and planned controlled clinical studies will further assess the long-term effects on metabolic health, lithogenic risk, and renal outcomes.