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Glomerular filtration rate (GFR) by clearance of inulin and creatinine and effective renal plasma flow (ERPF) by para‐aminohippurate clearance was investigated in 8 normal volunteers on low protein (LP) and high protein (HP) diet for 6 days in the basal state and after a mixed protein‐rich test meal. Plasma immunoreactive insulin (IRI), glucagon (IRG) and growth hormone (IRHGH) were followed before and after the test meal. GFR was higher on HP than on LP diet and increased within one hour after the test meal. ERPF also increased significantly after the meal on LP diet. IRI increased maximally at 60 min after the test meal and then declined gradulally. IRG increased after a latency period of 90 min and IRHGH consistently did not change. Since the increase in GFR was significant already one hour after the test meal, i.e. before IRG was changed, we conclude that glucagon is not a mediator of the protein‐induced increased in GFR. Neither insulin nor growth hormone appeared to be involved.

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Conservative therapy in advanced chronic renal failure is based on low-protein diet. Precautions have to be taken so that the patient does not develop protein deficiency. By supplementing low-protein diets with essential amino acids orally (as tablets) this risk can be minimized. Uremic patients have specific requirements for some amino acids which can be fulfilled by modifying the composition of the amino acid preparation. By supplementing a low-protein diet (–0.3 g protein/kg B.W./day) with an amino acid mixture which contains proportionally more valine and less leucine and isoleucine than prescribed by the Rose formula and, in addition, histidine and tyrosine. the amino acid abnormalities in plasma and muscle can be improved and nitrogen equilibrium maintained.

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