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Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease

Author

Listed:
  • Che-Hsiung Wu
  • Ya-Wen Yang
  • Szu-Chun Hung
  • Ko-Lin Kuo
  • Kwan-Dun Wu
  • Vin-Cent Wu
  • Tsung-Cheng Hsieh
  • for the National Taiwan University Study Group on Acute Renal Failure (NSARF)

Abstract

Background: The benefit of alpha-Ketoanalogues (KA) supplementation for chronic kidney disease (CKD) patients that followed low-protein diet (LPD) remains undetermined. Methods: We extracted longitudinal data for all CKD patients in the Taiwan National Health Insurance from January 1, 2000 through December 31, 2010. A total of 1483 patients with anemic advanced CKD treated with LPD, who started KA supplementation, were enrolled in this study. We analyzed the risks of end stage renal disease and all-cause mortality using Cox proportional hazard models with influential drugs as time-dependent variables. Results: A total of 1113 events of initiating long-term dialysis and 1228 events of the composite outcome of long-term dialysis or death occurred in patients with advanced CKD after a mean follow-up of 1.57 years. Data analysis suggests KA supplementation is associated with a lower risk for long-term dialysis and the composite outcome when daily dosage is more than 5.5 tablets. The beneficial effect was consistent in subgroup analysis, independent of age, sex, and comorbidities. Conclusions: Among advanced CKD patients that followed LPD, KA supplementation at an appropriate dosage may substantially reduce the risk of initiating long-term dialysis or of developing the composite outcome. KA supplementation represents an additional therapeutic strategy to slow the progression of CKD.

Suggested Citation

  • Che-Hsiung Wu & Ya-Wen Yang & Szu-Chun Hung & Ko-Lin Kuo & Kwan-Dun Wu & Vin-Cent Wu & Tsung-Cheng Hsieh & for the National Taiwan University Study Group on Acute Renal Failure (NSARF), 2017. "Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-17, May.
    • Handle: RePEc:plo:pone00:0176847
    DOI: 10.1371/journal.pone.0176847
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    References listed on IDEAS

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    1. Chi-Shin Wu & Mei-Shu Lai & Susan Shur-Fen Gau & Sheng-Chang Wang & Hui-Ju Tsai, 2014. "Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
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