Introduction

Chronic Kidney Disease (CKD) affects over 10% of the global population and leads to progressive muscle loss, protein-energy wasting (PEW), and metabolic complications.¹² Nutrition plays a pivotal role in managing both dialysis and non-dialysis patients—especially in optimizing protein type and quantity.

1. The Double Challenge in CKD Nutrition

• Patients need sufficient protein to preserve lean body mass.³
• Excess nitrogen from poorly metabolized protein can burden kidneys.⁴

This is why balanced protein blends—particularly combinations of plant-based proteins (rice + pea) and animal-derived proteins (whey + keto analogs)—are gaining scientific traction.

2. Rice + Pea Protein: A Plant-Based Synergy

• Rice is low in lysine but rich in methionine, while pea is rich in lysine.
• Together, they provide a complete amino acid profile.⁵
• Lower in phosphorus and potassium, ideal for CKD patients.⁶
• Less acid load compared to animal protein—beneficial in metabolic acidosis management.³

3. Whey Protein + Keto Analog Combination

• Whey protein supports muscle protein synthesis through leucine and BCAAs.⁷
• Keto analogs (non-nitrogenous essential amino acids) provide nutritional support without increasing nitrogen load.⁸
• Helps reduce uremic toxins and delays dialysis in pre-dialysis patients.⁹

4. Clinical Benefits of Balanced Protein Blends

• Improve nitrogen balance without increasing uremia.¹⁰
• Preserve muscle mass and strength, reducing sarcopenia risk.
• Reduce markers of inflammation and oxidative stress.¹¹ ¹²
• Better GI tolerance and compliance compared to single protein systems.

5. Application Across CKD Stages

• Non-Dialysis CKD (Stages 3–5): Low-protein diet (0.6–0.8 g/kg) with keto analogs.
• Dialysis Patients: Higher protein needs (1.2–1.5 g/kg), with whey and rice-pea support.

6. Formulation Takeaway

Core11’s renal-specific formulations (Entrifed HP and LP) integrate:

• Whey peptides + isolate for rapid absorption
• Rice + pea protein for low phosphorus load
• Keto analogs for nitrogen control
• Balanced amino acid profile to support strength, recovery, and renal safety

Conclusion

Balanced protein blends are the cornerstone of modern CKD nutrition. With the right synergy, they not only meet metabolic demands but protect kidney function. Core11's approach reflects these principles to offer safe, effective, and clinically aligned renal nutrition.

References

1. Nosaka N, et al. Combining plant proteins to achieve complete amino acid profile. J Nutr Sci Vitaminol. 2017;63(2):92–97.
2. Kalantar-Zadeh K, Fouque D. Nutritional management of chronic kidney disease. N Engl J Med. 2017;377(18):1765–1776.
3. Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391–398.
4. Kopple JD. National Kidney Foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001;37(1 Suppl 2):S66–S70.
5. Koeth RA, et al. Acid load and plant-based diets in CKD. Clin J Am Soc Nephrol. 2019;14(5):712–720.
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7. Aparicio M, et al. Keto acid supplementation and protein-restricted diets in CKD. Nephrol Dial Transplant. 2009;24(2):353–362.
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10. Cupisti A, et al. Nutritional support in renal patients: plant-based vs. animal protein. Clin Nutr. 2018;37(4):1123–1130.
11. Ikizler TA, Burrowes JD, Byham-Gray LD, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1–S107.
12. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–272.