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논문분류	춘계학술대회 초록집
제목	The Impact of Low-Protein Diet on Residual Renal Function in Dialysis Patients: A Systematic Review and Meta-Analysis
저자	Ahmed Elsayed
출판정보	2026; 2026(1):
키워드	protein, dialysis, metaanlysis
초록	Objectives: Preservation of residual renal function (RRF) in dialysis patients is associated with improved survival and quality of life. While low-protein diets (LPDs) are routinely recommended in pre-dialysis chronic kidney disease, their role after dialysis initiation remains controversial. This study evaluated the effects of LPDs on RRF and nutritional parameters in patients receiving dialysis. Methods: We searched PubMed, Cochrane Library, Web of Science, and Embase from inception to July 2025 for prospective studies comparing LPDs (≤0.8 g/kg/day) with standard protein intake in adult dialysis patients. Primary outcomes included glomerular filtration rate (GFR) and urine volume. Secondary outcomes were serum phosphorus, albumin, and nutritional indices. Random-effects models were applied. Subgroup analyses explored dialysis modality and ketoacid supplementation. Results: Six prospective studies involving 612 participants met inclusion criteria. Follow-up ranged from 4 to 12 months. Compared with standard diet, LPD was associated with better preservation of RRF at 12 months (MD 1.52 mL/min; 95% CI 0.42–2.61; I² = 28%) and a slower decline in daily urine volume (MD 540 mL; 95% CI 120–960; I² = 35%). Serum phosphorus levels were significantly lower in the LPD group (MD −0.68 mg/dL; 95% CI −0.95 to −0.41), while serum albumin was modestly higher (MD 0.32 g/dL; 95% CI 0.12–0.52). Subgroup analysis suggested greater RRF preservation in patients receiving ketoacid-supplemented LPDs. Sensitivity analyses confirmed robustness of results. Conclusion: In dialysis patients, adherence to a structured low-protein diet—particularly when supplemented with ketoacids—may preserve residual renal function while improving phosphorus control without compromising nutritional status. Larger randomized trials are warranted to confirm long-term safety and clinical benefits.
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