A 4 YEARS STUDY IN DIABETIC CHRONIC KIDNEY DISEASE
PATIENTS ON KETOAMINOACIDS TREATMENT IN BUCHAREST.
RESULTS AFTER 1-YEAR FOLLOW-UP
ILEANA TEODORU 1, EMILIA RUSU 2*, GABRIELA RADULIAN 2
1National of Diabetes Nutrition and Metabolic Diseases ”N.C. Paulescu”, Ion Movila 5-7, Bucharest, Romania
2University of Medicine and Pharmacy ”Carol Davila”, Dionisie Lupu 37, Bucharest, Romania
*corresponding author: emiliarusumd@yahoo.com
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Abstract:
We initiated a 4-year prospective cohort study on 200 patients with type 1 and type 2 diabetes mellitus and stage 4 chronic
renal disease (CKD) on ketodiet (very low-protein diet with 0.3 g protein/kg/day supplemented with ketoanalogues of
essential aminoacids. We present the results of compliant and dietary non-compliant patients, for the first year, analysed at
baseline, 6 and 12 months. The primary endpoint of the study was the reduction of renal function decline (decline in
glomerular filtration rate estimated eGFR/year). The results of the first 20 patients completing one year of follow-up
demonstrated that compliant patients had a slower decline of eGFR/year of 1.4 mL/min/1.73 m2/year vs. 4.1 mL/min/1.73
m2/year (p = 0.006), better serum bicarbonate (p = 0.006) and better parathyroid hormone levels (p = 0.04), while the
nutritional status and glycaemic control remained unchanged. The ketodiet in compliant diabetic patients with CKD provides
better outcomes, regarding nutritional safety parameters.

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