{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:45:56Z","timestamp":1790034356705,"version":"4.0.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007308","name":"Swedish Medical Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007308","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stockholm County Council ALF"},{"DOI":"10.13039\/501100008035","name":"Njurfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008035","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018713","name":"Center for Innovative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Italian Society of Nephrology"},{"DOI":"10.13039\/501100002997","name":"Dutch Kidney Foundation","doi-asserted-by":"publisher","award":["SB 142"],"award-info":[{"award-number":["SB 142"]}],"id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A low-protein diet (LPD) is recommended to patients with advanced chronic kidney disease (CKD), whereas geriatric guidelines recommend a higher amount of protein. The aim of this study was to evaluate the safety of LPD treatment in older adults with advanced CKD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The EQUAL study is a prospective, observational study including patients \u226565\u00a0years of age with an incident estimated glomerular filtration rate &amp;lt;20\u00a0ml\/min\/1.73\u00a0m2 in six European countries with follow-up through 6\u00a0years. Nutritional status was assessed by a 7-point subjective global assessment (SGA) every 3\u20136\u00a0months. Prescribed diet (g protein\/kg of bodyweight) was recorded on every study visit; measured protein intake was available in three countries. Time to death and decline in nutritional status (SGA decrease of \u22652\u00a0points) were analysed using marginal structural models with dynamic inverse probability of treatment and censoring weights.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1738 adults (631 prescribed LPD at any point during follow-up), there were 1319 with repeated SGA measurements, of which 267 (20%) decreased in SGA \u22652\u00a0points and 565 (32.5%) who died. There was no difference in survival or decrease in nutritional status for patients prescribed a LPD \u22640.8\u00a0g\/kg ideal bodyweight {odds ratio [OR] for mortality 1.15 [95% confidence interval (CI) 0.86\u20131.55)] and OR for decrease in SGA 1.11 [95% CI 0.74\u20131.66]} in the adjusted models. In patients prescribed a LPD &amp;lt;0.6\u00a0g\/kg ideal bodyweight, the results were similar. There was a significant interaction with LPD and older age &amp;gt;75\u00a0years, lower SGA and higher comorbidity burden for both mortality and nutritional status decline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In older adults with CKD approaching end-stage kidney disease, a traditional LPD prescribed and monitored according to routine clinical practice in Europe appears to be safe.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfae077","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T05:29:03Z","timestamp":1711603743000},"page":"1867-1875","source":"Crossref","is-referenced-by-count":13,"title":["The safety of a low-protein diet in older adults with advanced chronic kidney disease"],"prefix":"10.1093","volume":"39","author":[{"given":"Karin","family":"Windahl","sequence":"first","affiliation":[{"name":"Division of Renal 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