EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Research objective. To evaluate effect of low-protein diet (LPD) balanced with essential amino and keto acids and high-nutrient mix on deceleration of renal impairment advance in patients suffering from systemic illnesses along with pre-dialytic stages of chronic kidney disease (CKD).

Materials and methods. 48 patients with 3^rd or 4^th stage of CKD caused by systemic illnesses (in 35 cases by systemic lupus erythematosus, 13 cases - by various forms of systemic vasculitis) were included in the research. The patients were divided into 3 groups according to the level of protein consumption and to the correlation between vegetable and animal proteins.

The 1^st group consisted of 18 patients with 3^rd and 4^th stages of CKD, they were on diet Nr. 1 which included 0,6 g/kg of protein per day – 0,4 g/kg of animal protein per day and 0,2 g/kg of food vegetable protein per day.

The 2^nd group consisted of 20 patients with 3^rd and 4^th stages of CKD, they were on diet Nr. 2 with the same total protein content but with higher vegetable protein content – 0,3 g/kg per day – due to adding high-purity soy protein (isolate) into food. The patients from both groups were prescribed an optimal complex of 0,1 g/kg of all essential amino and keto acids per day.

The 3^rd group (comparison group) consisted of 10 patients with 3^rd and 4^th stages of CKD. The patients from the comparison group were on a normal diet (protein consumption from 1,1 g/kg to 1,3 g/kg per day) during the observation period (24-48 months) according to their personal motivation.

The patients’ nutritional status was evaluated on the basis of anthropometric data and other evaluation parameters. Protein consumption and caloric value of food were calculated on the basis of 3-day diet diary.

Results. Nutritional status disorders were detected in almost half of 48 patients with systemic illnesses and ^rd and 4^th stages of CKD (50%). Both options of low-protein diet were tolerated well, they provided nutritional disorders correction in the patients who had had the disorders before the research began and prophylaxis of nutritional disorders in the rest of the patients of the 1^st and the 2^nd groups. Along with the renal impairment progression in the patients of the 3^rd group (control), the frequency of nutritional status disorders grew by 1,5 times (from 40% to 60%). Drop in glomerular filtration rate (GFR) was registered in the patients who had been on low-protein diet for a year and more, especially with addition of high-nutrient mix.

Conclusion. Early (on pre-dialytic stage) limitation of protein consumption (0,6 g/kg per day) along with adding to dietary intake essential amino and keto acids and high-nutrient mix affect positively nutritional status of patients with CKD and provides decrease of GFR.