The compliance with supplemented diet by chronic uremics and their nutritional status

The compliance with the low-protein, supplemented diet is facilitated or hindered by psychological, social and toxic (severe uremia) factors; however, the most important factor which induces good compliance in patients is the fear of dialysis. The early effect of poor compliance is the appearance of intoxication related to renal failure and the consequent appearance of the uremic syndrome. The assessment of compliance with the low-protein intake is done quite easily by measuring urea appearance; however, regular clinical and laboratory controls are mandatory: anthropometric measurements, evaluation of the serum concentrations of proteins (especially those having a rapid turnover), and the evaluation of thyroid function--which is depressed in a state of malnutrition and improves following nutritional therapy--are adequate for detecting a state of malnutrition following poor compliance.