Protein intake and chronic kidney disease: literature review, 2003 to 2008.
PROTEIN-RESTRICTED DIETS have been used for decades to alleviate uremic symptoms, to prevent complications such as metabolic acidosis and renal osteodystrophy, and to improve complications such as abnormal glucose metabolism and hypertension in patients with advanced chronic kidney disease (CKD). Moreover, clinical trial evidence suggests that protein-restricted diets can slow the rate of progression in CKD or delay the start of dialysis in predialytic CKD. However, concerns are frequently raised about the safety and benefits of protein-restricted diets. Recent publications (2003 to 2008) clearly support the contention that controlled protein restriction (low-protein diets or keto acid/amino acidsupplemented very low protein diets) during the predialysis phase does not lead to malnutrition or influence mortality negatively at the start of dialysis or during subsequent treatment with renal replacement therapy.