[Effect of very low protein diet on the progression of chronic renal failure--a case report]

Low protein diet has been a very important clinical manipulation to delay the progression of chronic renal failure. However very low protein diet (less than 30 g/day) is not popular because of concern about malnutrition due to protein restriction, and the difficulty and trouble in making palatable dish. A 48 year old man with chronic renal failure has been on a 20-30 g protein-restricted diet more than three years with no remarkable defect in his daily life, with adequate nutrition, and with very enjoyable and variable daily menus. The rate of progression of chronic renal failure was markedly slowed. Serum creatinine level was 6.9 mg/dl when he started the diet control and it took more than three years for the creatinine level reached to 15.5 mg/dl with no troublesome clinical findings or symptoms. For successful protein restricted dietary treatment, the following several ideas have been helpful: promoting the patient's understanding of the disease and treatment; abundant use of specifically made low protein, high caloric foods such as starch noodles and rice; adoption of creative menus for the patient; and using a free diet a few days a month. The results indicate that we have to again consider the effect of the very low protein (30-20 g/day) diet in slowing the progression of chronic renal failure without nutritional disturbance or restriction of the patient's palatability.