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Health effects of the New Nordic Renal Diet in patients with stage 3 and 4 chronic kidney disease, compared to habitual diet: A randomized trial

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

DOI

  • Nikita Misella Hansen, Rigshospitalet
    • ,
  • Anne-Lise Kamper, Rigshospitalet
    • ,
  • Marianne Rix, Rigshospitalet
    • ,
  • Bo Feldt-Rasmussen, Rigshospitalet
    • ,
  • Jens Leipziger
  • Mads Vaarby Sørensen
  • Peder Berg
  • Arne Astrup, Department of Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark.
    • ,
  • Louise Salomo, Rigshospitalet

BACKGROUND: Chronic kidney disease (CKD) leads to an accumulation of waste products and causes adverse cardiometabolic effects.

OBJECTIVE: We investigated the health effects of the New Nordic Renal Diet (NNRD), a novel meal pattern reduced in phosphorus, protein, and sodium.

METHODS: A 26-week randomized trial compared the NNRD with a habitual diet. The NNRD group received weekly home deliveries of food and recipes. Monthly study visits included fasting blood samples, 24h urine samples, blood pressure and anthropometric measurements. Intention-to-treat analysis used linear mixed-effects models.

RESULTS: Sixty patients, mean estimated glomerular filtration rate (eGFR) 34 ml/min/1.73 m2, BMI 25-27 kg/m2 were included, 58 completed. Metabolic syndrome was present in 53% (NNRD group), and 57% (control group). The NNRD group (n=30) reduced their 24h urine phosphorus excretion by 19% [-153 mg (95% CI; -210, -95)], control group (n=30) (no change), between-group difference -171 mg (95% CI; -233, -109, p<0.001). Proteinuria was reduced by 39% in the NNRD group [-0.33 g/d (95% CI; -0.47, -0.18)], control group (no change), between-group difference -0.34 g/d (95% CI; -0.52, -0.17, p<0.001). Plasma urea was reduced by -1.5 mmol/L in the NNRD group (95% CI; -2.1, -0.9), control group (no change), between-group difference -1.4 mmol/L (95% CI; -2.0, -0.7, p<0.001). Systolic blood pressure fell by -5.2 mmHg in the NNRD group (95% CI; -8.4, -2.1), control group (no change), between-group difference -3.9 mmHg (95% CI; -7.6, -0.2, p=0.04). The NNRD group lost -1.7 kg (95% CI; -2.6, -0.8), control group (no change), between-group difference -2.0 kg (95% CI; -3.0, -1.0, p<0.001). There were no effects on eGFR during the 26-week intervention.

CONCLUSION: NNRD in moderate CKD reduces phosphorus excretion, proteinuria, systolic blood pressure, and weight, mainly by reducing abdominal fat.

CLINICAL TRIAL REGISTRY: NCT04579315.

OriginalsprogEngelsk
TidsskriftAmerican Journal of Clinical Nutrition
Sider (fra-til)1042-1054
Antal sider13
ISSN0002-9165
DOI
StatusUdgivet - 2023

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