Can I postpone renal replacement therapy (RRT) like dialysis?

Proteins are important for various functions in your body, including strengthening of muscles and enhancing the immune system, your kidneys cannot remove proteins correctly. Eating a limited amount of protein is therefore especially important for sufferers of CKD to reduce waste products which harm the kidney. As part of a non-invasive, conservative treatment approach, a protein-restricted diet supplemented with keto acids can postpone the start of dialysis.

What are keto acids?

Keto acids are substances that can be transformed into amino acids by the body. They do not contribute to nitrogen waste products, which would be additional stress for an impaired kidney. Thereby, they help to postpone the start of dialysis and improve the quality of life.

For how long can I postpone dialysis with keto acid supplementation?

Study data show that CKD patients can delay the start of dialysis for almost 1 year (10 months) with a keto acids supplemented very low protein diet.

Source: Brunori G, Viola BF, Parrinello G et al. Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis 2007;49:569-580.

Can I take keto acids in CKD without protein restriction?

As high amounts of proteins can cause deleterious waste products, keto acids should always be combined with a protein restricted diet. Keto acids function as a substitute for amino acids and will be transformed into the building blocks within the body. Thereby, keto acids ensure that the body receives the right amount of amino acids for various functions (e.g. repair of tissue) without causing additional deleterious waste products.

Why is a protein restricted diet important in predialysis?

Wastes derived from catabolising protein have to be excreted via your kidneys. In chronic kidney disease patients, when the kidney function is impaired, the waste products cannot be eliminated properly. As the waste products are poison for the body, patients who have not received dialysis yet, are advised to restrict their protein intake. Therefore, fewer wastes will be generated while consuming a protein-restricted diet, and the kidneys are disburdened.

Suffering from CKD, what is a patient supposed/allowed to eat?

In general, it is recommended to eat low amounts of sodium (especially table salt), low amounts of phosphate (e.g. seafood, cereals, chocolate, bean products etc.) and sufficient calories. Furthermore, patients in the predialysis stage should eat low amounts of protein.

Which foods should I avoid during my protein restricted diet in predialysis?

Since a protein-restricted diet is mainly a vegetarian diet, meat, fish, eggs, cheese, milk/milk products are only allowed in very limited amounts. Please talk to your doctor or dietitian to find out about your daily protein intake.

How do I know which treatment options fit me best?

As this has to be decided upon your disease history and individual situation, please ask your doctor or dietitian.