Effect of Applying 6% Low-Protein Formula to Dietary Advice in Elderly CKD Patients: A Randomized Control Trial

Background: The majority of researches have suggested the benefit of low-protein diet (LPD) could delay renal function progression in chronic kidney disease(CKD), but LPD increases the risk of malnutrition. The propose of this study to determine the effectiveness of dietary advices used by 6% low protein formula (6% LPF) for elderly CKD patients. Methods: Patient were recruited aged over 65 years old who were diagnosed stages 3-5 CKD .There were randomized to general LPD advice (control group) or LPD advice combined with application 6% LPF (intervention group) for renal dietitian during 3 months treatment. 6% LPS were prescribed daily, providing 400 kcal energy, 6 g of protein. The data analyzed were measured body weight (BW), body mass index (BMI), hand grip strength (HGS)in nutrition status and blood urea nitrogen (BUN), creatinine and estimated glomerular filtration rate (eGFR) in kidney function parameter. Results: 95 patients enrolled, and 47 completed of this study was distribution to intervention group (n=24) and control group (n=23). During the study period, HGS was maintain in intervention group but decreased significantly in control group (P<0.02) However, BW and BMI in both group were no significant differences. BUN was significantly reduced in intervention group (p = 0.003) but not control group (p = 0.059). There were no differences in creatinine and eGFR between groups at baseline to 3 months. Conclusions: Compared with routine LPD prescription, which combined with supplement 6% LPF was associated with maintained nutrition status and prevention on of renal failure. Our findings suggested that 6% LPF was a complementary strategy routine LPD education protocol.