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This pilot trial aims to assist the design of a larger trial on the efficacy and safety of\n                    <jats:sc>d<\/jats:sc>\n                    \u2010alanine intake on kidney function in patients with CKD. This pilot, open\u2010label, randomized controlled trial will enroll 24 patients with sustained albuminuria or proteinuria. Participants will be randomized in a 1:1 ratio to receive 3\u00a0g of\n                    <jats:sc>d<\/jats:sc>\n                    \u2010alanine supplementation per day for 12 weeks or standard care alone. The primary endpoint will be change in albuminuria from baseline to 12 weeks. The secondary endpoints include changes in estimated glomerular filtration rate and other clinical parameters. Safety will be evaluated according to adverse events and laboratory parameters. The findings of this trial are expected to help design a larger\u2010scale trial of\n                    <jats:sc>d<\/jats:sc>\n                    \u2010alanine and support further development of\n                    <jats:sc>d<\/jats:sc>\n                    \u2010alanine as a novel nutrition management for CKD.\n                  <\/jats:p>","DOI":"10.1002\/cbdv.202500746","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T17:19:27Z","timestamp":1753118367000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>d<\/scp>\n                    \u2010Alanine Supplementation for Chronic Kidney Disease: A Study Protocol for a Pilot Randomized Controlled Trial"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4108-5229","authenticated-orcid":false,"given":"Megumi","family":"Oshima","sequence":"first","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Toyama","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"},{"name":"Department of Nephrology Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Nakade","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goro","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Koshino","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taichiro","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Sako","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiori","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoaki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Kitajima","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Mizushima","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihiko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Tokumaru","sequence":"additional","affiliation":[{"name":"Department of Nutrition Kanazawa University Hospital  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Mita","sequence":"additional","affiliation":[{"name":"KAGAMI INC.  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