NATURAL-HISTORY OF NUTRITION IN CHRONIC-RENAL-FAILURE

Dietetic manipulation significantly influences the progression of rena l failure in laboratory animals. Clinical results in humans are contra dictory. The aim of the study was epidemiological research on a large sample of kidney disease patients to verify whether renal failure infl uences nutrient intake before dietetic manipulation. Four hundred and forty-one consecutive, non-selected adult patients with renal insuffic iency (creatinine 133-963 mu mol, mean 301 +/- 178 mu mol in male, 288 +/- 156 mu mol/l in female) and 43 kidney disease patients without re nal failure were enrolled in the prospective study in the period 1988- 1995. Interview at the time of the first nephrological check was perfo rmed by only one dietician; the record by recall of intake over 7 days with quantitative assessment was collected with the assistance of nut ritional dossier and photographic measures. The patients with renal fa ilure consume energy, proteins, lipids and carbohydrates in lesser qua ntities than the national population of the same geographical area, bu t the total lipid and monounsaturated fatty acid intake is higher comp ared with Italian: dietary reference values. In patients with renal fa ilure mean protein intake was 1.02 +/- 0.2 g/kg/day in males and 0.96 +/- 0.2 g/kg/day in females; mean lipid intake was 1.10 +/- 0.2 g/kg/d ay in males and 1.17 +/- 0.3 g/kg/day in females; mean carbohydrate in take was 3.7 +/- 1.1 g/kg/day in males and 3.49 +/- 1 g/kg/day in fema les. The nutrition alterations observed in chronic renal failure may b e a biological adaptation due to neurological changes affecting the se nse of taste.