A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease

A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease

<i>Background and Objectives</i>: We conducted a meta-analysis to assess the impact of nitrogen-free substitutes for essential amino acids on the progression of chronic kidney disease (CKD). <i>Materials and Methods</i>: A comprehensive literature review conducted up to Novem...

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Main Authors: Mohamed S. Imam, Lama Saud Turki Alrasheedi, Saleh Ali Hassan Alyami, Mahdi Mohammed Ahmed Aljamaan, Khaled Sami Khaled Alnaim, Hussam Mohsen Ayesh Alenzi, Nouf Nawaf Alnufeai, Daad Adnan Saad Almalki, Abdullah S. Alanazi, Saud Saad Frais Alotaibi, Naif Fahad Mashaan Alshaibani, Mohamed E. A. Abdelrahim, Basma M. E. Mohamed
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
Subjects:
very-low-protein diet
chronic kidney disease
nitrogen-free analogs
nutrition status
kidney functions
conventional low-protein diet
Online Access:https://www.mdpi.com/1648-9144/61/3/423
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Summary:<i>Background and Objectives</i>: We conducted a meta-analysis to assess the impact of nitrogen-free substitutes for essential amino acids on the progression of chronic kidney disease (CKD). <i>Materials and Methods</i>: A comprehensive literature review conducted up to November 2024 identified 15 studies that involved 1596 participants with CKD at baseline; among them, 797 were on very-low-protein diets (LPDs) enriched with nitrogen-free analogs (NFA), while 799 followed a standard LPD. <i>Results</i>: A very-LPD utilizing NFA showed significantly improved estimated glomerular filtration rate (MD, 1.00; 95% CI, 0.35–1.64, <i>p</i> = 0.002), reduced serum creatinine (MD, −0.44; 95% CI, −0.75 to −0.13, <i>p</i> = 0.006), decreased blood urea nitrogen (MD, −35.34; 95% CI, −64.27 to −6.42, <i>p</i> = 0.02), and lower parathyroid hormone levels (MD, −1.25; 95% CI, −2.33 to 0.18, <i>p</i> = 0.02) when compared to a standard LPD in patients with CKD. Nevertheless, the very-LPD with NFA resulted in no significant differences in serum albumin (MD, 0.08; 95% CI, −0.03 to 0.19, <i>p</i> = 0.14), serum cholesterol (MD, −17.25; 95% CI, −42.79 to 8.29, <i>p</i> = 0.19), serum phosphorus (MD, −0.41; 95% CI, −0.97 to 0.15, <i>p</i> = 0.15), and serum calcium (MD, 0.16; 95% CI, −0.06 to 0.39, <i>p</i> = 0.16) compared to a typical LPD in subjects with CKD. <i>Conclusions</i>: A very-LPD supplemented with NFA showed a notably higher estimated glomerular filtration rate, decreased serum creatinine levels, lower blood urea nitrogen, and reduced parathyroid hormone levels; however, there were no significant differences observed in serum albumin, serum cholesterol, serum phosphorous, and serum calcium when compared to a standard LPD in individuals with CKD. Additional research is necessary to confirm these results.
ISSN:1010-660X
1648-9144

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