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
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Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/423
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author 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
author_facet 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
author_sort Mohamed S. Imam
collection DOAJ
description <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.
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spelling doaj-art-6b2f261e452e457797e5ef0b10f0155f2025-08-20T02:42:22ZengMDPI AGMedicina1010-660X1648-91442025-02-0161342310.3390/medicina61030423A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal DiseaseMohamed S. Imam0Lama Saud Turki Alrasheedi1Saleh Ali Hassan Alyami2Mahdi Mohammed Ahmed Aljamaan3Khaled Sami Khaled Alnaim4Hussam Mohsen Ayesh Alenzi5Nouf Nawaf Alnufeai6Daad Adnan Saad Almalki7Abdullah S. Alanazi8Saud Saad Frais Alotaibi9Naif Fahad Mashaan Alshaibani10Mohamed E. A. Abdelrahim11Basma M. E. Mohamed12Department of Clinical Pharmacy, National Cancer Institute, Cairo University, Fom El Khalig Square, Kasr Al-Aini Street, Cairo 11796, EgyptCollege of Pharmacy, Northern Border University, Rafha 91911, Saudi ArabiaCollege of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi ArabiaCollege of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi ArabiaCollege of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi ArabiaCollege of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi ArabiaCollege of Pharmacy, Taif University, Taif 21944, Saudi ArabiaCollege of Pharmacy, Taif University, Taif 21944, Saudi ArabiaMedical College School of Health and Social Care, Swansea University, Swansea SA1 8EN, UKCollege of Pharmacy, Shaqra University, Shaqra 11961, Saudi ArabiaCollege of Pharmacy, Shaqra University, Shaqra 11961, Saudi ArabiaClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62574, EgyptClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62574, Egypt<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.https://www.mdpi.com/1648-9144/61/3/423very-low-protein dietchronic kidney diseasenitrogen-free analogsnutrition statuskidney functionsconventional low-protein diet
spellingShingle 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
A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
Medicina
very-low-protein diet
chronic kidney disease
nitrogen-free analogs
nutrition status
kidney functions
conventional low-protein diet
title A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
title_full A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
title_fullStr A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
title_full_unstemmed A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
title_short A Meta-Analysis Examining the Impact of Consuming Nitrogen-Free Analogs of Essential Amino Acids on the Progression of Chronic Renal Disease
title_sort meta analysis examining the impact of consuming nitrogen free analogs of essential amino acids on the progression of chronic renal disease
topic very-low-protein diet
chronic kidney disease
nitrogen-free analogs
nutrition status
kidney functions
conventional low-protein diet
url https://www.mdpi.com/1648-9144/61/3/423
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