Skip to main content
SpringerLink
Log in

Low-Protein Diets for Chronic Renal Failure

  • Chapter
Nutritional Treatment of Chronic Renal Failure

Part of the book series: Topics in Renal Medicine ((TIRM,volume 7))

Abstract

Considering the rationale and the purposes of low-protein diets (LPDs) for Chronic renal failure (CRF) (Chapter 18), it is evident that they should have several common properties: a) They should supply limited amounts of nitrogen that should, however, be qualitatively and quantitatively adequate for equilibrium of the nitrogen balance. b) They should supply limited amounts of Pi and Na but should ensure a high caloric intake (mostly from carbohydrates) to reduce protein (PR) breakdown. c) They should be satisfactorily accepted by patients so as to facilitate compliance. d) They should be as easy as possible to prepare and their cost should be as low as possible. e) The quality and amount of fats should be the same as in diets for lowering serum lipids, as CRF patients have often hyperlipemia (Chapter 8), which probably contributes to the decline of renal function [1]. Finally, f) the severity of the restrictions should correlate with the severity of CRF (see Chapter 24).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Moorhead JF, Chan MR, Varjze Z: (1986) The role of abnormalities of lipid metabolism on the progression of renal disease. In: Mitch WE, Brenner BM, Stein JS (eds) Contemporay Issues in Nephrology, Vol 14: The Progressive Nature of Renal Disease. New York: Churchill Livingstone, pp 133–148.

    Google Scholar 

  2. Giovannetti S, Maggiore Q: (1964) A low-nitrogen diet with proteins of high biological value for severe chronic uremics, Lancet i:1000–1004.

    Google Scholar 

  3. Berlyne GM, Shaw AB, Nilwaraugkur S: (1965) Dietary treatment of chronic renal failure. Experiences with a modified Giovannetti diet. Nephron 2:129–147.

    Article  PubMed  CAS  Google Scholar 

  4. Monasterio G, Giovannetti S, Maggiore Q: (1965) The place of low-protein diet in the treatment of chronic uremia. Panminerva Med 7:479–484.

    PubMed  CAS  Google Scholar 

  5. Herndon RF, Freeman S, Cleveland AS: (1968) Protein requirement in the chronic renal insufficient patient. 52:235–246.

    Google Scholar 

  6. Anderson CF, Nelson RA, Margie JP, Jonson WJ, Hunt LC: (1973) Nutritional therapy for adults with renal disease. JAMA 223:68–72.

    Article  PubMed  CAS  Google Scholar 

  7. Hood CEA, Beale KJ, Housley J, Hardwicke J: (1969) Dialyzed egg as nitrogen source in dietary control of chronic renal failure. Lancet i:479–482.

    Article  Google Scholar 

  8. Ford J, Philips ME, Toye FE: (1969) Nitrogen balance in patients with chronic renal failure on diet containing varying quantities of protein. Br Med J 1:735–740.

    Article  PubMed  CAS  Google Scholar 

  9. Kapple JD, Sorensen MK, Coburn JW, et al: (1968) Controlled comparison of 20 g and 40 g protein diet in the treatment of chronic uremia. Am J Clin Nutr 21:553–564.

    Google Scholar 

  10. Kapple JD, Coburn JW: (1973) Metabolic studies of low-protein diets in uremia. I. Nitrogen and potassium. Medicine 52:583–595.

    Article  Google Scholar 

  11. Ronsman JB, Donker AJM, Meiyer S, Sluiter WJ, Piers-Becht TPM, Van der Hem GK: (1986) Two year’s experience with protein restriction in chronic renal failure. Contr Nephrol 53:109–120.

    Google Scholar 

  12. Maschio G, Oldrizzi L, Tessitore N, D’Angelo A, Volvo A, Lupo A, Loschiavo C, Fabris A, Gammaro L, Rugiu C, Panzetta G: (1982) Effects of dietary protein and phosphorus restrictions on the progression of chronic renal failure. Kidney Int 22:371–376.

    Article  PubMed  CAS  Google Scholar 

  13. Maschio G, Oldrizzi L, Tessitore N, D’Angelo A, Volvo A, Lupo A, Loschiavo C, Fabris A, Gammaro L, Rugiu C, Panzetta G: (1983) Early dietary protein and phosphorus restriction is effective in delaying the progression of chronic renal failure. Kidney Int 24(Suppl 16): S273-S277.

    Google Scholar 

  14. Acchiardo S, Moore L, Cockrell S: (1982) Evolution of dietary treatment in predialysis patients (abstr). Kidney Int 24(Suppl 16):s346.

    Google Scholar 

  15. Barsotti G, Giannoni A, Morelli E, Lazzeri M, Vlamis I, Baldi R, Giovannetti S: (1984) The decline of renal function slowed by very low phosphorus intake in chronic renal patients following a low nitrogen diet. Clin Nephrol 21:54–59.

    PubMed  CAS  Google Scholar 

  16. Quirin M: (1966) Experimentelle Untersuchungen zur-eiweis-sarnen diät bei chronisher Nierenkrankungen. In: Mertz DP, Kluthe R (eds) Aktuelle Problem der klinishen Nephrologie. Stuttgart: Thieme.

    Google Scholar 

  17. Kluthe R, Quirin M, Oechseen D: (1967) Kartoffel-Ei-diät bei fortgeschrittener Niereninsuffizienz. Med Klin 62:1020–1034.

    PubMed  CAS  Google Scholar 

  18. Kofranyi E, Jekat F: (1964) Die Wertigkeit gemischter protein. Hoppe-Seylers Z Physiol Chem 335:174–186.

    Article  PubMed  CAS  Google Scholar 

  19. Kofranyi E, Müller-Wecker M: (1972) Biological value and minimum protein requirement of healthy humans. In: Klutle R, Burton B, Berlyne GM, (eds) Uremia. Stuttgart: Thieme pp 245–249.

    Google Scholar 

  20. Klutle R, Oechseen D, Quirin M, Jesdisky HJ: (1972) Six years experience with a special low-protein diet. In Klutle R, Burton B, Berlyne GM (eds) Stuttgart: Uremia Thieme, pp 250–256.

    Google Scholar 

  21. Abdulla M, Andersson I, Asp NG, Bertelsen K, Birkhed D, Denker I, Johanson CG, Jagerstardt M, Kolar K, Nair BN, Nilsson-Ehle M, Norden A, Rassner S, Akesson B, Ockerman PA: (1981) Nutrient intake and health status of vegans. Chemical analysis of diets using the duplicate portion sampling tecnique. Am J Clin Nutr 34:2464–2477.

    PubMed  CAS  Google Scholar 

  22. Kuksis A, Marai L, Myher JJ, Geber K: (1976) Identification of plant sterols in plasma and red blood cells of man and experimental animals lipids 11:581–586.

    CAS  Google Scholar 

  23. Sanders TAB: (1978) The health and nutritional status of vegans. Plant Food Man 2:181–193.

    CAS  Google Scholar 

  24. Kurtha AN, Ellis FR: (1970) The nutritional, clinical and economical aspects of vegan diet. Plant Food Human Nutr 2:13–22.

    Google Scholar 

  25. Shaw RL: (1969) Incapanna: A low-cost vegetable mixture and its commercial application. Plant Food Human Nutr 2:99.

    Google Scholar 

  26. Anon: (1968) Symposium on the role of plant foods in solving the world food problem. Plant Food Human Nutr 1:11.

    Google Scholar 

  27. Smith EB: (1975) A guide to good eating the vegetarian way. J Nutr Educ 7:109–118.

    Google Scholar 

  28. Wiseman MJ, Hunt R, Viberti GC: (1987) Dietary composition and renal function in healthy subjects. Nephron 46:37–42.

    Article  PubMed  CAS  Google Scholar 

  29. Nitzan Z, Liener IE: (1976) Studies on the digestibility and retention of nitrogen and amino acids in rats fed raw and heated soy flour. J Nutr 106:292–299.

    Google Scholar 

  30. Giordano C: (1963) Use of exogenous and endogenous urea for protein synthesis in normal and uremic subjects. J Lab Clin Med 6:231–246.

    Google Scholar 

  31. Kapple JD: (1978) Treatment with low-protein and amino-acid diets in chronic renal failure. In: Proc VII Intern Congr of Nephrology, Canada, June 18–23, pp 497–507.

    Google Scholar 

  32. Bergström J, Fürst P, Noree LO: (1975) Treatment of chronic uremic patients with proteinpoor diet and oral supply of essential animo acids. Clin Nephrol 3:187.

    PubMed  Google Scholar 

  33. Norée LO, Bergström J: (1975) Treatment of chronic uremic patients with protein-poor diet and oral supply of essential amino acids. II Clinical results of long-term treatment. Clin Nephrol 3:195–203.

    PubMed  Google Scholar 

  34. Fröhling PT, Schmicker R, Vetter K: (1980) Conservative treatment with an amino acid supplemented low-protein diet in chronic renal failure. Am J Clin Nutr 33:1667–1672.

    PubMed  Google Scholar 

  35. Heidland A, Kult J, Roker A, et al.: (1978) Evolution of essential amino acids and keto acids in uremic patients on low-protein diet. Am J Clin Nutr 31:1784–1792.

    PubMed  CAS  Google Scholar 

  36. Alvestrand A, Bergström J: (1984) Nutritional management. In: Suki WN, Massry SG (eds) Therapy of renal disease and related disorder. Boston: Martinus Nijhoff, pp 459–480.

    Google Scholar 

  37. Barsotti G, Lazzeri M, Cristofano C, Cerri M, Lupetti S, Giovannetti S: (1986) The role of metabolic acidosis in causing uremic hyperphosphatemia. Mineral Electr Metab 12:103–106.

    CAS  Google Scholar 

  38. Schloerb PR: (1966) Essential L-amino acid administration in uremia. Am J Med Sci 252: 650–659.

    Article  PubMed  CAS  Google Scholar 

  39. Walser M, Coulter AW, Dighe S, Crantz FR: (1973) The effect of keto analogues of essential amino acids in severe chronic uremia. J Clin Invest 52:678–690.

    Article  PubMed  CAS  Google Scholar 

  40. Walser M: (1975) Keto acids in the treatment of uremia. Clin Nephrol 3:180–186.

    PubMed  CAS  Google Scholar 

  41. Holliday D, Madigan M, Chaemers RA, Purkiss P, Ell S, Bergström J, Fürst P, Neuhauser M, Richards P: (1981) The degree of conversion of alpha-keto acids of valine and phenlalanine in health and uremia. Quart J Med 50:53–62.

    Google Scholar 

  42. Mitch WE, Collier VV, Walser M: (1981) Treatment of chronic renal failure with branched chain keto acids plus the other essential amino acids or their nitrogen-free analogues. In: Walser M, Williamson JR (eds) Metabolism and Clinical Implications of Branched Chain Amino and Keto Acids. Amsterdam: Elsevier/North Holland, pp 587–592.

    Google Scholar 

  43. Walser M, La France ND, Ward L, Van Duyn MA: (1987) Progression of chronic renal failure in patients given ketoacids following amino acids. Kidney Int 32:123–128.

    Article  PubMed  CAS  Google Scholar 

  44. Zimmerman EW, Meisinger E, Weinel B, Strauch M: (1979) Essential amino acid and keto analogue supplementation: An alternative to unrestricted protein intake in uremia. Clin Nephrol 11:71–78.

    Google Scholar 

  45. Sauci SW, Fachmann W, Kraut H: (1986) Food composition and nutrition tables. For-schungsalstalt für Lebensmittelchemie, Garching, Munchen. Stuttgart: Wissenschaftliche Verlagsgesellschaft.

    Google Scholar 

  46. Rudman D, Bleier JC: (1983) Nutritional Requirements. In: Petersdorf RG, Adams RD, Braunwold E, Isselhacher KJ, Martin JB, Wilson JD (eds). Harrison’s Principles of Internal Medicine, 10th edition. New York: McGraw Hill Book Company, pp 426–433.

    Google Scholar 

Download references

Authors
  1. S. Giovannetti
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clinica Medica I°, University of Pisa, 56100, Pisa, Italy

    Sergio Giovannetti

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Kluwer Academic Publishers, Boston

About this chapter

Cite this chapter

Giovannetti, S. (1989). Low-Protein Diets for Chronic Renal Failure. In: Giovannetti, S. (eds) Nutritional Treatment of Chronic Renal Failure. Topics in Renal Medicine, vol 7. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1583-4_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-1583-4_20

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8877-0

  • Online ISBN: 978-1-4613-1583-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation