1. Introduction
diabetic CKD, CKD, chronic kidney disease, LPD
CHRONIC KIDNEY DISEASE (CKD)
High-energy, low-protein formulas (HE-LPFs) are commonly used as oral nutritional supplements (ONSs) to help provide extra calories to patients who are adhering to a low-protein diet (LPD) after diagnosis with chronic kidney disease (CKD). This randomized controlled trial aimed to evaluate the efficacy and safety of an HE-LPF as either a partial or a total replacement for one meal in pre-dialysis CKD patients. Stage 4–5 CKD patients received either a once-daily HE-LPF (HE-LPF group) or normal food (control group) for a period of 4 weeks while following an LPD. Overall, 73 patients who completed the study were included in the intention-to-treat population. After analyzing the 3-day food records, the HE-LPF group experienced a significant decrease in the percentage of energy derived from protein (Chronic kidney disease (CKD) is a common chronic condition with an estimated global prevalence of approximately 10% [One of the foundations of this therapeutic approach is the restriction of protein intake to levels of approximately 0.55–0.6 g/kg/day in nondiabetic CKD patients and 0.6–0.8 g/kg/day in diabetic CKD patients [Previous research has shown that low-protein ONSs can improve both adherence to an LPD and nutritional status during pre-dialysis CKD [