The Microbiome and Protein Carbamylation: Potential Targets for Protein-Restricted Diets Supplemented with Ketoanalogues in Predialysis Chronic Kidney Disease
نویسندگان
چکیده
In chronic kidney disease (CKD), metabolic derangements resulting from the interplay between decreasing renal excretory capacity and impaired gut function contribute to accelerating progression enhancing risk of complications. To protect residual improve quality life in conservatively managed predialysis CKD patients, current guidelines recommend protein-restricted diets supplemented with essential amino acids (EAAs) their ketoanalogues (KAs). clinical studies, such an approach improved nitrogen balance other secondary disturbances, translating benefits, mainly delayed initiation dialysis. There is also increasing evidence that a diet KAs slows down progression. present review article, recent insights into role KA/EAA-supplemented delaying are summarized, possible mechanistic underpinnings, as protein carbamylation dysbiosis, elucidated. Emerging suggests lowering urea levels may reduce carbamylation, which might decreased morbidity mortality. Protein restriction, alone or combination KA/EAA supplementation, modulates dysbiosis decreases generation gut-derived uremic toxins associated, e.g., cardiovascular disease, inflammation, energy wasting, Future studies warranted assess effects on microbiome, toxins, well markers carbamylation.
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ژورنال
عنوان ژورنال: Nutrients
سال: 2023
ISSN: ['2072-6643']
DOI: https://doi.org/10.3390/nu15163503