ROLE OF NUTRITION IN PREVENTION OF THE PROGRESSION OF RENAL-DISEASE

In rats with renal disease, low-protein diets slow the decline in rena l function, histologic damage, and mortality. Low-protein (and phospho rus) diets can also ameliorate uremic symptoms, secondary hyperparathy roidism, and metabolic acidosis in patients with chronic renal failure . Albeit controversial, evidence also suggests that dietary protein re striction can slow the rate of progression of renal failure and the ti me until end-stage renal failure. These dietary regimens appear to be safe and patients with chronic renal failure are able to activate norm al compensatory mechanisms designed to conserve lean body mass when di etary protein intake is restricted. When low-protein diets are prescri bed, patients should be closely monitored to assess dietary compliance and to ensure nutritional adequacy. Evidence that the spontaneous int ake of dietary protein decreases in patients with progressive chronic renal failure who consume unrestricted diets should not be construed a s an argument against the use of low-protein diets. Rather, it is a pe rsuasive argument to restrict dietary protein intake in order to minim ize complications of renal failure while preserving nutritional status .