| Theme | Emaciation in Chronic Dialysis Patients | |
|---|---|---|
| Title | Do low protein diets cause malnutrition? | |
| Publish Date | 2000/04 | |
| Author | Sonoo Mizuiri | Department of Nephrology, Toho University School of Medicine |
| Author | Ken Sakai | Department of Nephrology, Toho University School of Medicine |
| [ Summary ] | Do low protein diets cause malnutrition? This question arises from the observation that hypoaluguminemia is associated with an increased mortality risk in hemodialysis patients. However, our observations showed that a pre-dialysis low protein diet did not affect dietary protein intake and nutritional parameters (alubumin, TG, BMI, Fat) during the first year of dialysis. Furthermore, reports by Walser et al. showed that survival rates during the first two years of dialysis were not adversely affected by a low protein diet and they were substatially better than survival rates reported nationwide. It is reported that either an usually low protein diet (0.6g/kg/day) or a very low protein diet (0.3g/kg/day) with essential amino acids or keto acids in patients with chronic renal failure showed neutral nitrogen balances. The largest study on dietary protein restriction (n=840) : "Modification of Diet in Renal Disease (MDRD)" study have confirmed the adequacy of protein restricted diets. Biochemical and anthropometric indices of nutritional status during follow ups (for three years) were generally well within normal limits in all MDRD study groups including patients on very low protein diets. The successful use of a low protein diet by patients with chronic renal failure (CRF) depends on ensuring that the requirements for other nutrients (energy and essential amino acids) are included and there is regular monitoring of dietary intake and nutritional status. |
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