The association between low protein diet and body composition, muscle function, inflammation, and amino acid-based metabolic profile in chronic kidney disease stage 3–5 patients

• Published in: Clinical nutrition ESPEN 2021-12, Vol.46, p.405-415
• Main Authors: Hsu, Heng-Jung, Yen, Chiung-Hui, Wu, I-Wen, Liu, Min-Hui, Cheng, Hsiu-Yun, Lin, Yi-Tsen, Lee, Chin-Chan, Hsu, Kuang-Hung, Sun, Chiao-Yin, Chen, Chun-Yu, Wang, Chao-Hung
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Amino acid; Amino Acids; Biomarker; Body Composition; Chronic kidney disease; Cross-Sectional Studies; Daily calorie intake; Diet, Protein-Restricted; Humans; Inflammation; Leucine; Low protein diet; Metabolome; Middle Aged; Muscles; Renal Insufficiency, Chronic
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2021.08.037

Chronic kidney disease (CKD) is a global burden in the world. Low protein diet (LPD) recommendation is suggested in CKD patients to avoid or defer dialysis initiation and slow down CKD progression. However, nutritional imbalance and protein energy wasting represent key worries. The amino acid-based metabolic profile may provide a sensitive biomarker to evaluate CKD patients' nutrition status with LPD recommendations. We conducted a cross-sectional study in CKD stage 3–5 patients who had received LPD recommendation to evaluate the association between LPD and traditional markers (including plasma levels of albumin, pre-albumin, transferrin, total iron-binding capacity), inflammation markers (including peripheral leukocyte count and plasma levels of high-sensitivity C-reactive protein), body composition, muscle strength, and physical function, and novel nutrition markers (including amino acid-based metabolic profile) in CKD stage 3–5 patients. In our study CKD stage 3–5 patients with the total number of 73, the mean age was around 71 ± 10 years old. The mean daily protein intake (DPI) was around 0.9 ± 0.3 g/kg/day and 25 (34%) patients met the recommended goal of DPI