Protein-restricted diets and progression of renal failure

Interest in dietary therapy of chronic uremia has reawakened because such therapy may slow or halt progression of renal insufficiency. The efficacies of three regimens: 0.6 g protein/kg/day; 0.3 g protein/kg/day plus essential amino acids, and 0.3 g protein/kg/day plus keto acid regimens, have been tested. Each can maintain nitrogen balance if properly administered but if dietary protein and/or the supplement are inadequate, muscle wasting will occur. Data showing that each can slow the rise in serum creatinine are presented. The problems with using serum creatinine, potential mechanisms for the effect on progression and methods for monitoring compliance are discussed.