Very-low-protein diets in chronic renal failure: nutrient content and guidelines for supplementation

The possibility that supplemented, very-low-protein diets may slow the progression of CRF increases the importance of that type of diet therapy (1). If the results are confirmed in large numbers of patients, it is likely that the supplements will become commercially available and will be used widely to treat patients with progressive renal failure. Adequate vitamin and mineral supplementation will be necessary in order to maintain good nutritional status. On the basis of previously reported data and the present results, supplemental thiamin, riboflavin, niacin, vitamin B-12, folic acid, pyridoxine, calcium, and possibly iron and zinc are recommended for patients treated with these very-low-protein diets. These recommendations are preliminary and may be altered as more long-term data are collected on the vitamin and mineral status of CRF patients.