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Appropriateness of Ketoanalogues of Amino Acids, Calcium Citrate, and Inulin Supplementation for CKD Management: A RAND/UCLA Consensus

2024; Multidisciplinary Digital Publishing Institute; Volume: 16; Issue: 17 Linguagem: Inglês

10.3390/nu16172930

2072-6643

Nadia Saavedra‐Fuentes, Enrique Carmona-Montesinos, Gilberto Castañeda‐Hernández, Israel Campos, Juan Carlos Castillo-Salinas, Javier Alberto Castillo-Tapia, Karla Guadalupe Del Castillo-Loreto, Juan Carlos Falcón-Martínez, Raquel Fuentes-García, Miguel Ángel García de León Guerrero, Victor García-García, Erika F. Gómez-García, Rafael González-Toledo, A. Berrocal Jaime, Kely Rely, Claudia Lerma, Luis E. Morales-Buenrostro, Mateo Quilantan-Rodriguez, Adrián Rodriguez-Matías, Felipe Octavio Rojas-Rodríguez, Rafael Valdez-Ortiz, Michael Wasung, Berenice Ceron-Trujillo, Edgar Ramírez-Ramírez,

Renal function and acid-base balance

Background: Current treatment for chronic kidney disease (CKD) focuses on improving manifestations and delaying progression. Nutritional approaches play a crucial role in CKD management, and various supplements have become available. Ketoanalogues of amino acids (KAs), calcium citrate, and inulin have been proposed as suitable supplements, yet their widespread use has been limited due to insufficient evidence. This study aimed to generate general guidance statements on the appropriateness of these supplements through a RAND/UCLA consensus process. Methods: A RAND/UCLA consensus panel was convened to evaluate the appropriateness of these supplements in different clinical scenarios. In this study, we present a subgroup analysis focusing on a panel of eleven clinical nephrologists from among the experts. Results: Supplementation of low-protein diets (LPDs) and very low-protein diets (VLPDs) with KA was considered appropriate to reduce manifestations and delay CKD outcomes, supplementation with calcium citrate is considered appropriate to reduce CKD manifestations, and supplementation with inulin is considered appropriate to delay CKD outcomes and manage comorbidities. Conclusions: Based on a combination of clinical experience and scientific evidence, the panel reached a consensus that KA supplementation of LPD and VLPD, calcium citrate, and inulin are appropriate in patients with CKD across various scenarios.