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Positive effects of protein restriction in patients with chronic kidney disease.
J Ren Nutr. 2008 May; 18(3):269-80.JR

Abstract

OBJECTIVES

The potential benefit or harm of low-protein diets (LPDs) for patients with chronic kidney disease has been debated. This study sought to investigate the effects of treatment with LPDs on nutritional markers, morbidity, and survival during subsequent dialysis. A second objective was to evaluate the effect of LPDs on renal function and the start of dialysis.

DESIGN

This was a retrospective study of medical records.

SETTING

The setting was an outpatient nephrology and dialysis clinic.

PATIENTS

One-hundred twenty-two renal patients were recruited from the central dialysis registry of one clinic. The patients had been followed by a nephrologist for > or =6 months before dialysis. Sixty-one patients were treated with LPDs, and an equal number of control patients not treated with LPDs were matched for sex, age, dialysis modality, diabetes, and start of dialysis.

MAIN OUTCOME MEASURES

Main outcome measures included weight and weight change, serum albumin, glomerular filtration rate, morbidity, and mortality.

RESULTS

There was less mean weight loss in the LPD group the year before dialysis (0.14 kg/month, compared with the control group at 0.36 kg/month, P < .05). The level of serum albumin was higher in the LPD group at the start of dialysis (P < .01). The mean rate of progression during the 6 months before dialysis was lower in the LPD group (4.1 mL/min/year) than in the control group (13.4 mL/min/year) (P < .001). The LPD group had fewer days of hospitalization at the start of dialysis than the control group (8.2 vs 15.4 days, respectively, P < .01). There was no difference in mortality between groups 1, 2, or 5 years after starting dialysis.

CONCLUSIONS

Low-protein diets can reduce patient morbidity, preserve renal function, relieve uremic symptoms and improve nutritional status. The results suggest that LPDs can postpone the start of dialysis for 6 months, and entail substantial cost-savings. Low-protein diets should be used more generally in the renal community.

Authors+Show Affiliations

Department of Molecular and Clinical Medicine, and Department of Nephrology, Sahlgrenska Academy, Göteborg University, Gothenburg, Sweden. Sintra.Eyre@vgregion.seNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18410883

Citation

Eyre, Sintra, et al. "Positive Effects of Protein Restriction in Patients With Chronic Kidney Disease." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 18, no. 3, 2008, pp. 269-80.
Eyre S, Attman PO, Haraldsson B. Positive effects of protein restriction in patients with chronic kidney disease. J Ren Nutr. 2008;18(3):269-80.
Eyre, S., Attman, P. O., & Haraldsson, B. (2008). Positive effects of protein restriction in patients with chronic kidney disease. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 18(3), 269-80. https://doi.org/10.1053/j.jrn.2007.11.013
Eyre S, Attman PO, Haraldsson B. Positive Effects of Protein Restriction in Patients With Chronic Kidney Disease. J Ren Nutr. 2008;18(3):269-80. PubMed PMID: 18410883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Positive effects of protein restriction in patients with chronic kidney disease. AU - Eyre,Sintra, AU - Attman,Per-Ola, AU - Haraldsson,Börje, PY - 2007/01/19/received PY - 2008/4/16/pubmed PY - 2008/6/12/medline PY - 2008/4/16/entrez SP - 269 EP - 80 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 18 IS - 3 N2 - OBJECTIVES: The potential benefit or harm of low-protein diets (LPDs) for patients with chronic kidney disease has been debated. This study sought to investigate the effects of treatment with LPDs on nutritional markers, morbidity, and survival during subsequent dialysis. A second objective was to evaluate the effect of LPDs on renal function and the start of dialysis. DESIGN: This was a retrospective study of medical records. SETTING: The setting was an outpatient nephrology and dialysis clinic. PATIENTS: One-hundred twenty-two renal patients were recruited from the central dialysis registry of one clinic. The patients had been followed by a nephrologist for > or =6 months before dialysis. Sixty-one patients were treated with LPDs, and an equal number of control patients not treated with LPDs were matched for sex, age, dialysis modality, diabetes, and start of dialysis. MAIN OUTCOME MEASURES: Main outcome measures included weight and weight change, serum albumin, glomerular filtration rate, morbidity, and mortality. RESULTS: There was less mean weight loss in the LPD group the year before dialysis (0.14 kg/month, compared with the control group at 0.36 kg/month, P < .05). The level of serum albumin was higher in the LPD group at the start of dialysis (P < .01). The mean rate of progression during the 6 months before dialysis was lower in the LPD group (4.1 mL/min/year) than in the control group (13.4 mL/min/year) (P < .001). The LPD group had fewer days of hospitalization at the start of dialysis than the control group (8.2 vs 15.4 days, respectively, P < .01). There was no difference in mortality between groups 1, 2, or 5 years after starting dialysis. CONCLUSIONS: Low-protein diets can reduce patient morbidity, preserve renal function, relieve uremic symptoms and improve nutritional status. The results suggest that LPDs can postpone the start of dialysis for 6 months, and entail substantial cost-savings. Low-protein diets should be used more generally in the renal community. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/18410883/Positive_effects_of_protein_restriction_in_patients_with_chronic_kidney_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(07)00267-1 DB - PRIME DP - Unbound Medicine ER -