biostudies-literatureUnknown40(12)Povero MFresenius Kabi<h4>Background</h4>Chronic kidney disease (CKD) is a global health concern with significant economic implications, particularly in the management of end-stage renal disease (ESRD), which often requires kidney replacement therapy such as dialysis or transplantation. The rising incidence of ESRD is expected to increase healthcare costs substantially by 2030. Dietary protein restriction is a cornerstone of managing CKD progression, and the use of ketoanalogues in very low-protein diets (VLPD) has shown promise in delaying dialysis initiation. This study evaluates the cost-effectiveness of a vegetarian ketoanalogue-supplemented VLPD (s-VLPD) compared with a low-protein diet (LPD) in patients with CKD stages 4 and 5 in Italy.<h4>Methods</h4>A Markov model was developed to simulate the health ouNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2372-2378https://www.ebi.ac.uk/biostudies/studies/S-EPMC12648053biostudies-literatureCost-effectiveness of a ketoanalogue-supplemented very low-protein diet in CKD.PMC12648053Povero MSimion TPradelli LfalseCost-effectiveness of a ketoanalogue-supplemented very low-protein diet in CKD.<h4>Background</h4>Chronic kidney disease (CKD) is a global health concern with significant economic implications, particularly in the management of end-stage renal disease (ESRD), which often requires kidney replacement therapy such as dialysis or transplantation. The rising incidence of ESRD is expected to increase healthcare costs substantially by 2030. Dietary protein restriction is a cornerstone of managing CKD progression, and the use of ketoanalogues in very low-protein diets (VLPD) has shown promise in delaying dialysis initiation. This study evaluates the cost-effectiveness of a vegetarian ketoanalogue-supplemented VLPD (s-VLPD) compared with a low-protein diet (LPD) in patients with CKD stages 4 and 5 in Italy.<h4>Methods</h4>A Markov model was developed to simulate the health ou2025-01-01T00:00:00Z2025 Nov2026-06-05T17:55:34.992Z2026-05-19T03:12:00.133ZS-EPMC126480534062741210.1093/ndt/gfaf123