Effects of dietary protein and phosphorus restriction on the progression of early renal failure

• DOI: 10.1038/ki.1982.184
• Publication Date: 2007-06-16T12:53:30Z
• Authors: Giuseppe Maschio; Lamberto Oldrizzi; Nicola Tessitore; Angela D'Angelo; Enrico Valvo; Antonio Lupo; Carmelo Loschiavo; Antonia Fabris; Linda Gammaro; Carlo Rugiu; Giovanni Panzetta
• Keywords: Adult; Adolescent; Phosphorus; Middle Aged; Prognosis; Phosphates; 03 medical and health sciences; 0302 clinical medicine; Nephrology; Renal Dialysis; Creatinine; Humans; Kidney Failure, Chronic; Calcium; chronic renal failure; progression; dietary restriction; Dietary Proteins; Aged

Three groups of patients with chronic renal failure were studied. Group 1 comprised 25 patients with a mean serum creatinine of 2.18 mg/dl and a mean arterial pressure of 117 mm Hg. Group 2 had 20 patients with a mean serum creatinine of 4.24 mg/dl and a mean arterial pressure of 119 mm Hg. All these patients were kept for 18 to 76 months on a diet containing about 40 kcal/kg, 0.6 g/kg of protein, 700 mg of phosphorus, and 1,000 to 1,500 mg of calcium (orally supplemented). Group 3 comprised 30 patients with a mean serum creatinine of 2.28 mg/dl and a mean arterial pressure of 116 mm Hg. They had followed no specific dietary regimen for 3 to 72 months, and their dietary calorie, protein, phosphorus, and calcium intakes averaged 35 kcal/kg, 70 g, 900 mg, and 800 mg, respectively. The plots of reciprocal creatinine against time gave slopes of -0.0008 and -0.0010 in patients in groups 1 and 2, and a slope of -0.020 in group 3 patients. The slopes of both groups 1 and 2 were statistically different (analysis of variance and "F" test, P less than 0.01) from that of group 3. No evidence of progressive protein and phosphorus depletion was observed in groups 1 and 2 patients. We conclude that a moderate dietary restriction of protein and phosphorus is an acceptable and effective regimen for delaying progression of functional deterioration in early renal failure.