History of Dietary Protein Therapy for the Treatment of Chronic Renal Disease from the Mid 1800s until the 1950s

Kopple, Joel D.

doi:10.1159/000063774

Cited by 7 publications

(3 citation statements)

References 34 publications

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“…Nevertheless, NT has a fundamental role in this medical setting and it has been used for years in the clinical practice with several goals. Initially, NT was basically used with the purpose of administrating a reduced amount of high biological value proteins in order to reduce endogenous urea generation and uremic symptoms [4]. Later, the interest of nephrologists focused on the possibility of delaying CKD progression with NT, but with fluctuating results [3].…”

Section: Introductionmentioning

confidence: 99%

Very Low Protein Diet for Patients with Chronic Kidney Disease: Recent Insights

Micco

Lullo

Bellasi

et al. 2019

JCM

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Use of nutritional therapy (NT) in chronic kidney disease (CKD) patients is still debated among nephrologists, but it represents a fundamental point in the conservative treatment of CKD. It has been used for years and it has new goals today, such as (1) the reduction of edema, diuretics, and blood pressure values with a low sodium-content diet; (2) the dose reduction of phosphate levels and phosphate binders; (3) the administration of bicarbonate with vegetables in order to correct metabolic acidosis and delay CKD progression; (4) the reduction of the number and the doses of drugs and chemical substances; and (5) the lowering of urea levels, the cure of intestinal microbioma, and the reduction of cyanates levels (such as indoxyl-sulphate and p-cresol sulphate), which are the most recent known advantages achievable with NT. In conclusion, NT and especially very low protein diet (VLPD) have several beneficial effects in CKD patients and slows the progression of CKD.

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Section: Introductionmentioning

confidence: 99%

Very Low Protein Diet for Patients with Chronic Kidney Disease: Recent Insights

Micco

Lullo

Bellasi

et al. 2019

JCM

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“…Dietary manipulation has been used for over a century in the treatment of kidney diseases. [1][2][3][4][5][6][7][8] This strategy is based on experimental reports that an excess of dietary protein can impair kidney function and aggravate the complications of uremia, whereas an excess of other dietary components can interfere with the protective effects of inhibitors of the renin-angiotensin-aldosterone system on the progression of chronic kidney disease (CKD). 1,[9][10][11][12][13][14] There is also evidence that the application of low-protein diets in patients with advanced CKD can slow the loss of residual kidney function while correcting certain symptoms of CKD by reducing the accumulation of unexcreted waste products.…”

mentioning

confidence: 99%

The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines

Moore

Byham‐Gray²,

Parrott³

et al. 2013

Kidney International

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The actual dietary protein intake of adults without and with different stages of chronic kidney disease is not known. To evaluate this we performed cross-sectional analyses of 16,872 adults (20 years of age and older) participating in the National Health and Nutrition Examination Survey 2001-2008 who completed a dietary interview by stage of kidney disease. Dietary protein intake was assessed from 24-h recall systematically collected using the Automated Multiple Pass Method. Complex survey analyses were used to derive population estimates of dietary protein intake at each stage of chronic kidney disease. Using dietary protein intake of adults without chronic kidney disease as the comparator, and after adjusting for age, the mean dietary protein intake was 1.30 g/kg ideal body weight/day (g/kgIBW/d) and was not different from stage 1 or stage 2 (1.28 and 1.25 g/kgIBW/d, respectively), but was significantly different in stage 3 and stage 4 (1.22 and 1.13 g/kgIBW/d, respectively). These mean values appear to be above the Institute of Medicine requirements for healthy adults and the NKF-KDOQI guidelines for stages 3 and 4 chronic kidney disease. Thus, the mean dietary protein intake is higher than current guidelines, even after adjusting for age.

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“…The other indication is to reduce the accumulation of potentially toxic compounds in patients with CKD and also, prevent or treat proteinenergy wasting (6,7). The relative interest in these two potential roles for treatment of CKD has varied greatly, at least since the 19th century (8). From the mid-1950s until about the mid-1970s, the focus of dietary therapy was primarily to reduce the accumulation of uremic toxins while preventing malnutrition (7).…”

Section: Introductionmentioning

confidence: 99%

Current Uses of Dietary Therapy for Patients with Far-Advanced CKD

Hanafusa

Lodebo

Kopple

2017

CJASN

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For several decades, inquiry concerning dietary therapy for nondialyzed patients with CKD has focused mainly on its capability to retard progression of CKD. However, several studies published in recent years indicate that, independent of whether diet can delay progression of CKD, well designed low-protein diets may provide a number of benefits for people with advanced CKD who are close to requiring or actually in need of RRT. Dietary therapy may both maintain good nutritional status and safely delay the need for chronic dialysis in such patients, offering the possibility of improving quality of life and reducing health care costs. With the growing interest in incremental dialysis, dietary therapy may enable lower doses of dialysis to be safely and effectively used, even as GFR continues to decrease. Such combinations of dietary and incremental dialysis therapy might slow the rate of loss of residual GFR, possibly reduce mortality in patients with advanced CKD, improve quality of life, and also, reduce health care costs. The amount of evidence that supports these possibilities is limited, and more well designed, randomized clinical trials are clearly indicated.

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History of Dietary Protein Therapy for the Treatment of Chronic Renal Disease from the Mid 1800s until the 1950s

Cited by 7 publications

References 34 publications

Very Low Protein Diet for Patients with Chronic Kidney Disease: Recent Insights

Very Low Protein Diet for Patients with Chronic Kidney Disease: Recent Insights

The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines

Current Uses of Dietary Therapy for Patients with Far-Advanced CKD

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