Introduction: Advanced chronic kidney disease (CKD) can be treated with conservative care or renal replacement therapies.CKD is associated with an increased risk of nephropathy progression, and death.Therefore, slow down CKD progression is crucial, and there is consensus regarding protein intake regulation benefit in delaying this progression.Ketoanalogues are nitrogen-free analogs of essential amino acids which supplements low protein diets.Thus, it was decided to evaluate if keto diet had benefit in reducing CKD progression.Material and Method: It was evaluated if there was a significant difference in CKD progression between two groups of stage 4-5 CKD patients: one group on keto diet, and one group with standard low protein diet.All patients received standard CKD treatment, and monthly eGFR (CKD-EPI) was documented.All evaluated parameters were compared between their initial and final values (delta value) in each group, and between the groups.Student and Wilcoxon tests were applied for data analysis. Results:From 140 stage 4-5 CKD old patients, 38 patients were randomly assigned to keto diet, and the rest (n: 102) were assigned to standard reduced protein diet (control group).Both groups were followed up during 12 months.There was no significant difference between initial and final eGFR values neither in keto nor in control groups.Additionally, there was no significant difference between eGFR delta values between the two groups. Conclusion:There was no significant eGFR in older CKD patients neither on keto diet nor on standard CKD diet.