{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:04:03Z","timestamp":1769519043090,"version":"3.49.0"},"reference-count":18,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU Next Generation EU","award":["09I03-03-V04-00211"],"award-info":[{"award-number":["09I03-03-V04-00211"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use of this method in patients with chronic kidney disease and a kidney transplantation. Materials: This was a retrospective monocentric study conducted by the transplant nephrology department in Martin, in which patients with chronic kidney disease, with or without kidney transplant therapy, who received a low-protein diet and supplementation with keto analogues were included (n = 59). The changes in their glomerular filtration rate, proteinemia, calcaemia, weight, and glycaemia and the side effects associated with a low-protein diet and keto analogue use were studied in the patients with chronic kidney disease with or without kidney transplantation. Results: The kidney transplant recipients had a significantly more advanced stage of chronic kidney disease (p = 0.0001) than the non-transplanted patients at the time of the prescription of the keto analogues (p = 0.0001). Furthermore, the kidney transplant recipients had a significantly longer follow-up period (p = 0.0001), with a difference of 27 months within subgroups. During the observed period, we recorded a decrease in glomerular filtration, but without statistical significance. In our group, we did not confirm a significant occurrence of adverse effects associated with a low-protein diet and keto analogues. Conclusion: Keto analogues reduce the progression of chronic kidney disease and stabilise glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with keto analogues is effective and safe for kidney transplant recipients after kidney transplantation.<\/jats:p>","DOI":"10.3390\/nu16234001","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T10:17:23Z","timestamp":1732270643000},"page":"4001","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Keto Analogues in Patients with Chronic Kidney Disease with or Without Kidney Transplantation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5156-5226","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Kleinov\u00e1","sequence":"first","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3303-2164","authenticated-orcid":false,"given":"T\u00edmea","family":"Blichov\u00e1","sequence":"additional","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8834-0365","authenticated-orcid":false,"given":"Karol","family":"Gra\u0148\u00e1k","sequence":"additional","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrej","family":"Koll\u00e1r","sequence":"additional","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-1425","authenticated-orcid":false,"given":"Matej","family":"Vnu\u010d\u00e1k","sequence":"additional","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8246-4268","authenticated-orcid":false,"given":"Ivana","family":"Dedinsk\u00e1","sequence":"additional","affiliation":[{"name":"Transplant-Nephrology Department, University Hospital Martin, Koll\u00e1rova 2, 036 01 Martin, Slovakia"},{"name":"Department of Internal Medicine I, Jessenius Medical Faculty, Comenius University, 036 01 Martin, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int. Suppl."},{"key":"ref_2","unstructured":"(2024, October 27). Siemens Healthcare Diagnostics. Chronic Kidney Disease: A Global Crisis. Available online: https:\/\/www.siemens-healthineers.com\/sk\/news\/chronic-kidney-disease.html."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chang, G., Shih, H.-M., Pan, C.-F., Wu, C.-J., and Lin, C.-J. (2023). Effect of Low Protein Diet Supplemented with Ketoanalogs on Endothelial Function and Protein-Bound Uremic Toxins in Patients with Chronic Kidney Disease. Biomedicines, 11.","DOI":"10.3390\/biomedicines11051312"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41581-022-00542-7","article-title":"Epidemiology of haemodialysis outcomes","volume":"18","author":"Bello","year":"2022","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"KDIGO (2024). Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int., 105, S117\u2013S314.","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1681\/ASN.2020010028","article-title":"The Effects of High-Protein Diets on Kidney Health and Longevity","volume":"31","author":"Ko","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_7","unstructured":"KDIGO (2024, October 27). Clinical Practice Guideline for Diabetes Managment in Chronic Kidney Disease, Quick Reference Guide. Available online: https:\/\/kdigo.org\/wp-content\/uploads\/2023\/03\/KDIGO-2022-Diabetes-Guideline-Quick-Reference-Guide.pdf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"111384","DOI":"10.1016\/j.nut.2021.111384","article-title":"Effects of ketoanalogues on skeletal muscle mass in patients with advanced chronic kidney disease: Real-world evidence","volume":"91\u201392","author":"Lin","year":"2021","journal-title":"Nutrition"},{"key":"ref_9","unstructured":"(2024, October 27). \u0160t\u00e1tny \u00dastav Pre Kontrolu Lie\u010div. (In Slovakia)."},{"key":"ref_10","unstructured":"Monique, E.C., and Srinivasan, B. (2024, September 14). Dietary Recommendations for Patients with Nondialysis Chronic Kidney Disease. Available online: https:\/\/www.uptodate.com\/contents\/dietary-recommendations-for-patients-with-nondialysis-chronic-kidney-disease."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Garneata, L., Mocanu, C.-A., Simionescu, T.P., Mocanu, A.E., Dragomir, D.R., and Mircescu, G. (2024). Low Protein Diet Reduces Proteinuria and Decline in Glomerular Filtration Rate in Advanced, Heavy Proteinuric Diabetic Kidney Disease. Nutrients, 16.","DOI":"10.3390\/nu16111687"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-023-42706-w","article-title":"The role of a low protein diet supplemented with ketoanalogues on kidney progression in pre-dialysis chronic kidney disease patients","volume":"13","author":"Ariyanopparut","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1053\/j.jrn.2011.09.006","article-title":"Keto Acid Therapy in Predialysis Chronic Kidney Disease Patients: Final Consensus","volume":"22","author":"Aparicio","year":"2012","journal-title":"J. Ren. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1093\/ndt\/gft092","article-title":"Vegetarian low-protein diets supplemented with keto analogues: A niche for the few or an option for many?","volume":"28","author":"Piccoli","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Li, A., Lee, H.-Y., and Lin, Y.-C. (2019). The Effect of Ketoanalogues on Chronic Kidney Disease Deterioration: A Meta-Analysis. Nutrients, 11.","DOI":"10.3390\/nu11050957"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s11255-017-1713-9","article-title":"Effect of restricted protein diet supplemented with keto analogues in end-stage renal disease: A systematic review and meta-analysis","volume":"50","author":"Jiang","year":"2018","journal-title":"Int. Urol. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Pereira, C.D., Guimar\u00e3es, C., Ribeiro, V.S., Vaz, D.C., and Martins, M.J. (2024). Low-Protein Diets, Malnutrition, and Bone Metabolism in Chronic Kidney Disease. Nutrients, 16.","DOI":"10.3390\/nu16183098"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bellizzi, V., Garofalo, C., Ferrara, C., and Calella, P. (2022). Ketoanalogue Supplementation in Patients with Non-Dialysis Diabetic Kidney Disease: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14030441"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/23\/4001\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:37:40Z","timestamp":1760114260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/23\/4001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":18,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["nu16234001"],"URL":"https:\/\/doi.org\/10.3390\/nu16234001","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]}}}