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Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet.
J Am Soc Nephrol. 2000 Apr; 11(4):708-716.JA

Abstract

Protein-restricted diets are prescribed in patients with chronic renal failure (CRF) to alleviate uremic symptoms and to slow the progression of CRF. The potential deleterious effects of protein restriction on nutritional status and clinical outcome of patients with CRF have raised concern. In this study, data were collected from 1985 to 1998 on 239 consecutive patients (age 50.2 +/- 15.6 yr) with advanced CRF (GFR 13.1 +/- 4.8 ml/min) to whom a supplemented very low protein diet (SVLPD) providing 0.3 g protein, 35 kcal, and 5 to 7 mg of inorganic phosphorus per kg per day was administered for a mean duration of 29.6 +/- 25.1 mo. The diet was supplemented with essential amino acids and ketoanalogs, calcium carbonate, iron, and multivitamins. During SVLPD, protein intake decreased from 0.85 +/- 0.23 to 0.43 +/- 0.11 g/kg per d, and body mass index and serum albumin concentration remained unchanged overall. Fourteen patients died during SVLPD; death was unrelated to nutritional parameters. Hemodialysis was initiated after SVLPD in 165 patients at a mean GFR of 5.8 +/-1.5 ml/min. During an average of 54 mo on hemodialysis, mortality was low (2.4% after 1 yr) and correlated to age only, not to nutritional parameters observed at the end of SVLPD. Similar results were obtained in 66 transplanted patients (12 were not dialyzed before transplantation). SVLPD can be safely used in patients with CRF without adverse effects on the clinical and nutritional status of the patients. Due to the preservation of nutritional status and the correction of uremic symptoms, the initiation of dialysis was deferred in these patients. The outcome of patients on renal replacement therapy is not affected by prior treatment with SVLPD during the predialysis phase of CRF.

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Authors+Show Affiliations

Aparicio M
Service de Néphrologie, Hôpital Pellegrin, Bordeaux, France.
Chauveau P
Association pour l'Usage du Rein Artificiel à Domicile en Aquitaine, Gradignan, France.
Précigout V
Service de Néphrologie, Hôpital Pellegrin, Bordeaux, France.
Bouchet JL
Centre de Traitement des Maladies Rénales Saint-Augustin, Bordeaux, France.
Lasseur C
Service de Néphrologie, Hôpital Saint-André, Bordeaux, France.
Combe C
Service de Néphrologie, Hôpital Saint-André, Bordeaux, France.

MeSH

AdolescentAdultAgedAged, 80 and overBicarbonatesDiet, Protein-RestrictedFemaleGlomerular Filtration RateHumansKidney Failure, ChronicKidney TransplantationMaleMiddle AgedNutritional StatusParathyroid HormoneProteinuriaRenal DialysisRenal Replacement TherapyRetrospective StudiesSurvival AnalysisTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10752530

Citation

Aparicio, Michel, et al. "Nutrition and Outcome On Renal Replacement Therapy of Patients With Chronic Renal Failure Treated By a Supplemented Very Low Protein Diet." Journal of the American Society of Nephrology : JASN, vol. 11, no. 4, 2000, pp. 708-716.
Aparicio M, Chauveau P, Précigout V, et al. Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet. J Am Soc Nephrol. 2000;11(4):708-716.
Aparicio, M., Chauveau, P., Précigout, V., Bouchet, J. L., Lasseur, C., & Combe, C. (2000). Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet. Journal of the American Society of Nephrology : JASN, 11(4), 708-716. https://doi.org/10.1681/ASN.V114708
Aparicio M, et al. Nutrition and Outcome On Renal Replacement Therapy of Patients With Chronic Renal Failure Treated By a Supplemented Very Low Protein Diet. J Am Soc Nephrol. 2000;11(4):708-716. PubMed PMID: 10752530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet. AU - Aparicio,Michel, AU - Chauveau,Philippe, AU - Précigout,Valérie DE, AU - Bouchet,Jean-Louis, AU - Lasseur,Catherine, AU - Combe,Christian, PY - 2000/4/7/pubmed PY - 2000/6/10/medline PY - 2000/4/7/entrez SP - 708 EP - 716 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 11 IS - 4 N2 - Protein-restricted diets are prescribed in patients with chronic renal failure (CRF) to alleviate uremic symptoms and to slow the progression of CRF. The potential deleterious effects of protein restriction on nutritional status and clinical outcome of patients with CRF have raised concern. In this study, data were collected from 1985 to 1998 on 239 consecutive patients (age 50.2 +/- 15.6 yr) with advanced CRF (GFR 13.1 +/- 4.8 ml/min) to whom a supplemented very low protein diet (SVLPD) providing 0.3 g protein, 35 kcal, and 5 to 7 mg of inorganic phosphorus per kg per day was administered for a mean duration of 29.6 +/- 25.1 mo. The diet was supplemented with essential amino acids and ketoanalogs, calcium carbonate, iron, and multivitamins. During SVLPD, protein intake decreased from 0.85 +/- 0.23 to 0.43 +/- 0.11 g/kg per d, and body mass index and serum albumin concentration remained unchanged overall. Fourteen patients died during SVLPD; death was unrelated to nutritional parameters. Hemodialysis was initiated after SVLPD in 165 patients at a mean GFR of 5.8 +/-1.5 ml/min. During an average of 54 mo on hemodialysis, mortality was low (2.4% after 1 yr) and correlated to age only, not to nutritional parameters observed at the end of SVLPD. Similar results were obtained in 66 transplanted patients (12 were not dialyzed before transplantation). SVLPD can be safely used in patients with CRF without adverse effects on the clinical and nutritional status of the patients. Due to the preservation of nutritional status and the correction of uremic symptoms, the initiation of dialysis was deferred in these patients. The outcome of patients on renal replacement therapy is not affected by prior treatment with SVLPD during the predialysis phase of CRF. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/10752530/Nutrition_and_outcome_on_renal_replacement_therapy_of_patients_with_chronic_renal_failure_treated_by_a_supplemented_very_low_protein_diet_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=10752530 DB - PRIME DP - Unbound Medicine ER -