Patients with
end-stage renal disease (
ESRD) die in the absence of
renal replacement therapy (RRT). In developing countries RRT is not uniformly available and treatment often relies on
conservative management and intermittent
peritoneal dialysis (IPD). This study investigates the possibility of using
acacia gum supplementation to improve the quality of life and provide children with
ESRD with a dialysis-free period. Three patients referred to our hospital with
ESRD during a 3-month period were enrolled in a therapeutic trial to investigate the efficacy of
acacia gum (1 g/kg per day in divided doses) as a complementary conservative measure aimed at improving the quality of life. Inclusion criteria included a pre-dialysis
creatinine clearance of <5 ml/min, current
dietary restrictions and supplementation, at least one dialysis session to control uremic symptoms, absence of life-threatening complications, and sufficient motivation to ensure compliance with the study protocol. One patient complied with the protocol for only 10 days and died after 6 months, despite IPD. Two patients completed the study. Both reported improved well-being. Neither became acidotic or uremic, and neither required dialysis during the study period. Both patients maintained urinary
creatinine and
urea levels not previously achieved without dialysis. In conclusion, dietary supplementation with
acacia gum may be an alternative to
renal replacement therapy to improve the quality of life and reduce or eliminate the need for dialysis in children with
ESRD in some developing countries.