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Effect of nonsupplemented low-protein diet on very late stage CRF.
MedLine Citation:
PMID:  12612948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There are few reports of the effect of a low-protein diet on very late-stage chronic renal failure (CRF), eg, serum creatinine level greater than 10 mg/dL (884 micromol/L). In this retrospective study, we examined the effects of a very low-protein diet in patients with very late-stage CRF. METHODS: A very low-protein diet (0.25 to 0.54 g/kg body weight/d [0.39 +/- 0.01g/kg body weight/d]) without supplementation of essential amino acids or keto analogues was administered to 76 patients with very late-stage CRF who had serum creatinine levels greater than 10 mg/dL (884 micromol/L). Twenty-one patients with the same serum creatinine level and protein intake of 0.55 to 1.2 g/kg body weight/d (0.68 +/- 0.03 g/kg body weight/d) were observed in lieu of controls. RESULTS: Blood urea nitrogen was significantly suppressed to 43.1 +/- 1.9 g/dL (15.4 +/- 0.7 mmol/L) in the low-protein group compared with 111.2 +/- 7.0 mg/dL (39.7 +/- 2.5 mmol/L; P < 0.001) in the control group. The rate of decline in glomerular filtration rate (creatinine clearance) was 36-fold slower with the low-protein diet (-7.1 +/- 1.0 versus -0.2 +/- 0.4 mL/mon, respectively; P < 0.001). Nutritional state in the low-protein group exceeded that of the control group. Consequently, the renal survival rate improved significantly (P < 0.0001). All patients in the control group were initiated on dialysis treatment within 6 months from a serum creatinine level of 10 mg/dL (884 micromol/L). Conversely, 58% of the low-protein group are still on predialysis treatment. CONCLUSION: A severe low-protein diet is effective not only in preventing deterioration in renal function, but also in maintaining nutritional state despite no supplementation of essential amino acids or keto analogues, even as serum creatinine level is more than 10 mg/dL (884 micromol/L).
Authors:
Terukuni Ideura; Miyuki Shimazui; Kumiko Higuchi; Hiroyuki Morita; Ashio Yoshimura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  41     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-03     Completed Date:  2003-03-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S31-4     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Nephrology, Showa University Fujigaoka Hospital, Aoba-ku, Yokohama-city, Kanagawa, Japan. ideura@showa-university-fujigaoka.gr.jp
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MeSH Terms
Descriptor/Qualifier:
Creatinine / blood
Diet, Protein-Restricted / methods*
Dietary Supplements*
Humans
Kidney Failure, Chronic / blood,  diet therapy*,  pathology*,  therapy
Middle Aged
Renal Replacement Therapy / trends
Retrospective Studies
Chemical
Reg. No./Substance:
60-27-5/Creatinine

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