[Individualized supplemented low-protein diet in patients with chronic kidney failure]

The possibility of developing protein-energy malnutrition poses a serious risk associated with long-term administration of a restrictive low-protein diet. We conducted a randomized prospective study designed to evaluate 36 patients with chronic renal failure in initial malnutrition (BMI 22%, albumin 35 milligrams, WQ 2.02). In 20 of these patients (Group I), low-protein diet was supplemented with ketoanalogs of essential amino acids along with a low-phosphate drink from casein-free protein. The diet of another 16 patients (Group II) was supplemented with a mixture of essential and non-essential amino acids of egg white. Three-month follow-up revealed a statistically significant improvement in selected metabolic parameters (Surea, albumin, WQ, valine HDL-CH cholesterol, SP and SCa), particularly in Group I (p < 0.01). In group II, the improvement was either not marked (p < 0.05) or no improvement was seen. Results of the study indicate that patients found to suffer from initial malnutrition require early dietary supplementation including ketoanalogs of essential amino acids and a special protein providing an adequate amount of energy.