Nutritional aspects of plasma protein metabolic studies: Long-term treatment of chronic uraemia by a very-low-protein diet supplemented with essential amino acids and keto analogues
About 20 years ago the experimental studies by Giordano1 and by Giovannetti and Maggiore2 introduced the use of especially designed low-protein diets for the long-term conservative treatment of chronic uraemic patients3–5. These diets provide the necessary amount of essential amino acids as proteins of high biological value2, the energy needs being supplied essentially by carbohydrates and lipids (see review in reference 6). This restricted protein intake was aimed at reducing as much as possible the toxic signs of uraemia, both by decreasing the retention of metabolic waste products from exogenous sources and by promoting the incorporation of urea nitrogen into non-essential amino acids7–9. However, the main limitation to the long-term efficacy of such diets is the fact that they do not provide any means of correcting the water and electrolyte disturbances of end-stage uraemia.
KeywordsEssential Amino Acid Residual Renal Function Uraemic Patient Double Tracer Fractional Catabolic Rate
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