Universität zu Köln

Oehm, Simon, Steinke, Konstantin, Schmidt, Johannes, Arjune, Sita, Todorova, Polina ORCID: 0000-0002-4728-224X, Lindemann, Christoph Heinrich, Woestmann, Fabian, Meyer, Franziska, Siedek, Florian, Weimbs, Thomas ORCID: 0000-0001-9423-5561, Mueller, Roman-Ulrich and Grundmann, Franziska . RESET-PKD: A pilot trial on short-term ketogenic interventions in autosomal dominant polycystic kidney disease. Nephrol. Dial. Transplant.. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2385

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Abstract

Background Ketogenic dietary interventions (KDI) have been shown to be effective in animal models of polycystic kidney disease (PKD), but data from clinical trials are lacking. Methods Ten autosomal dominant PKD (ADPKD) patients with rapid disease progression were enrolled at visit V1 and initially maintained a carbohydrate-rich diet. At V2, patients entered one of the two KDI arms: a 3-day water fast (WF) or a 14-day ketogenic diet (KD). At V3, they resumed their normal diet for 3-6 weeks until V4. At each visit, magnetic resonance imaging kidney and liver volumetry was performed. Ketone bodies were evaluated to assess metabolic efficacy and questionnaires were used to determine feasibility. Results All participants [KD n = 5, WF n = 5; age 39.8 +/- 11.6 years; estimated glomerular filtration rate 82 +/- 23.5 mL/min/1.73 m(2); total kidney volume (TKV) 2224 +/- 1156 mL] were classified as Mayo Class 1C-1E. Acetone levels in breath and beta-hydroxybutyrate (BHB) blood levels increased in both study arms (V1 to V2 average acetone: 2.7 +/- 1.2 p.p.m., V2 to V3: 22.8 +/- 11.9 p.p.m., P = .0006; V1 to V2 average BHB: 0.22 +/- 0.08 mmol/L, V2 to V3: 1.88 +/- 0.93 mmol/L, P = .0008). Nine of 10 patients reached a ketogenic state and 9/10 evaluated KDIs as feasible. TKV did not change during this trial. However, we found a significant impact on total liver volume (Delta TLV V2 to V3: -7.7%, P = .01), mediated by changes in its non-cystic fraction. Conclusions RESET-PKD demonstrates that short-term KDIs potently induce ketogenesis and are feasible for ADPKD patients in daily life. While TLV quickly changed upon the onset of ketogenesis, changes in TKV may require longer-term interventions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Oehm, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinke, Konstantin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Arjune, Sita UNSPECIFIED UNSPECIFIED UNSPECIFIED Todorova, Polina UNSPECIFIED orcid.org/0000-0002-4728-224X UNSPECIFIED Lindemann, Christoph Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Woestmann, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Siedek, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Weimbs, Thomas UNSPECIFIED orcid.org/0000-0001-9423-5561 UNSPECIFIED Mueller, Roman-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Grundmann, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-674964
DOI:	10.1093/ndt/gfac311
Journal or Publication Title:	Nephrol. Dial. Transplant.
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2385
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ORTHOLOGOUS MOUSE MODEL; LOW-CARBOHYDRATE DIETS; LOW-FAT; LDL CHOLESTEROL; WEIGHT-LOSS; PROGRESSION; HEALTHY; RESTRICTION; REDUCTION; IMPACT Multiple languages Transplantation; Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67496