No change of hyperleptinemia despite a decrease in insulin concentration in patients with chronic renal failure on a supplemented very low protein diet

2000 ◽  
Vol 36 (6) ◽  
pp. 1201-1206 ◽  
Author(s):  
Valérie de Précigout ◽  
Philippe Chauveau ◽  
Caroline Delclaux ◽  
Wael El Haggan ◽  
Laurence Baillet ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Insulin Concentration ◽  
Low Protein Diet ◽  
Low Protein ◽  
Very Low Protein Diet

scholarly journals Supplemented very low protein diet ameliorates responsiveness to erythropoietin in chronic renal failure

2003 ◽  
Vol 64 (5) ◽  
pp. 1822-1828 ◽  
Author(s):  
Biagio R. Di Iorio ◽  
Roberto Minutolo ◽  
Luca De Nicola ◽  
Vincenzo Bellizzi ◽  
Fausta Catapano ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Very Low Protein Diet

scholarly journals Nutrition and Outcome on Renal Replacement Therapy of Patients with Chronic Renal Failure Treated by a Supplemented Very Low Protein Diet

2000 ◽  
Vol 11 (4) ◽  
pp. 708-716 ◽  
Author(s):  
MICHEL APARICIO ◽  
PHILIPPE CHAUVEAU ◽  
VALÉRIE DE PRÉCIGOUT ◽  
JEAN-LOUIS BOUCHET ◽  
CATHERINE LASSEUR ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Replacement Therapy ◽  
Nutritional Status ◽  
Replacement Therapy ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Nutritional Parameters ◽  
Low Protein ◽  
Very Low Protein Diet

Abstract. Protein-restricted diets are prescribed in patients with chronic renal failure (CRF) to alleviate uremic symptoms and to slow the progression of CRF. The potential deleterious effects of protein restriction on nutritional status and clinical outcome of patients with CRF have raised concern. In this study, data were collected from 1985 to 1998 on 239 consecutive patients (age 50.2 ± 15.6 yr) with advanced CRF (GFR 13.1 ± 4.8 ml/min) to whom a supplemented very low protein diet (SVLPD) providing 0.3 g protein, 35 kcal, and 5 to 7 mg of inorganic phosphorus per kg per day was administered for a mean duration of 29.6 ± 25.1 mo. The diet was supplemented with essential amino acids and ketoanalogs, calcium carbonate, iron, and multivitamins. During SVLPD, protein intake decreased from 0.85 ± 0.23 to 0.43 ± 0.11 g/kg per d, and body mass index and serum albumin concentration remained unchanged overall. Fourteen patients died during SVLPD; death was unrelated to nutritional parameters. Hemodialysis was initiated after SVLPD in 165 patients at a mean GFR of 5.8 ± 1.5 ml/min. During an average of 54 mo on hemodialysis, mortality was low (2.4% after 1 yr) and correlated to age only, not to nutritional parameters observed at the end of SVLPD. Similar results were obtained in 66 transplanted patients (12 were not dialyzed before transplantation). SVLPD can be safely used in patients with CRF without adverse effects on the clinical and nutritional status of the patients. Due to the preservation of nutritional status and the correction of uremic symptoms, the initiation of dialysis was deferred in these patients. The outcome of patients on renal replacement therapy is not affected by prior treatment with SVLPD during the predialysis phase of CRF.

scholarly journals Can Renal Replacement Be Deferred by a Supplemented Very Low Protein Diet?

1999 ◽  
Vol 10 (1) ◽  
pp. 110-116
Author(s):  
MACKENZIE WALSER ◽  
SYLVIA HILL
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Diabetic Patients ◽  
Renal Survival ◽  
Low Protein ◽  
Very Low Protein Diet

Abstract. Patients with chronic renal failure are commonly started on renal replacement therapy (RRT) as soon as (or, in some centers, before) the usual criteria for severity are met,i.e., GFR <10 ml/min for nondiabetic patients and <15 ml/min for diabetic patients. To determine whether RRT can safely be deferred beyond this point, adults with all types of chronic renal failure who met these criteria on presentation (23 patients) or who reached these levels of severity during treatment (53 patients) were managed conservatively until RRT was judged necessary by their chosen dialysis or transplantation team, without input into this decision from the present authors. Patients were prescribed a very low protein diet (0.3 g/kg) plus supplemental essential amino acids and/or ketoacids and followed closely. The intervals between the time at which GFR became less than 10 ml/min (15 ml/min in diabetic patients) and the date at which renal replacement therapy was started were used as estimates of renal survival on nutritional therapy. Kaplan—Meier analysis showed median renal survival of 353 d. Acidosis and hypercholesterolemia were both predictive of shorter renal survival. Signs of malnutrition did not develop. Final GFR averaged 5.6 ± 1.9 ml/min. Two patients died; thus, annual mortality was only 2.5%. Hospitalizations totaled 19 in 93 patient-years of treatment, or 0.2 per year. Thus, these well motivated patients with GFR <10 ml/min (<15 ml/min in diabetic patients) were safely managed by diet and close follow-up for a median of nearly 1 yr without dialysis. It is concluded that further study of this approach is indicated.

Antioxidant Effects of a Supplemented Very Low Protein Diet in Chronic Renal Failure

1997 ◽  
Vol 22 (1-2) ◽  
pp. 313-320 ◽  
Author(s):  
Evelyne Peuchant ◽  
Marie-Christine Delmas-Beauvieux ◽  
Liliane Dubourg ◽  
Marie-José Thomas ◽  
Annie Perromat ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Very Low Protein Diet ◽  
Antioxidant Effects

Comparison of a Vegetable-Based (Soya) and an Animal-Based Low-Protein Diet in Predialysis Chronic Renal Failure Patients

Nephron ◽  
1998 ◽  
Vol 79 (2) ◽  
pp. 173-180 ◽  
Author(s):  
N. Soroka ◽  
D.S. Silverberg ◽  
M. Greemland ◽  
Y. Birk ◽  
M. Blum ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Predialysis Chronic Renal Failure

scholarly journals Survival on dialysis among chronic renal failure patients treated with a supplemented low-protein diet before dialysis.

1995 ◽  
Vol 6 (5) ◽  
pp. 1379-1385
Author(s):  
J Coresh ◽  
M Walser ◽  
S Hill
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Mortality Rate ◽  
Serum Creatinine ◽  
Dietary Treatment ◽  
Mortality Rates ◽  
Protein Restriction ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein

Concerns have been raised about the possibility of protein restriction resulting in malnutrition and poor subsequent survival on dialysis. However, no studies have examined patients treated with protein restriction to determine their subsequent survival on dialysis. This study prospectively monitored 67 patients with established chronic renal failure (mean initial serum creatinine of 4.3 mg/dL) who were treated with a very low-protein diet (0.3 g/kg per day) supplemented with either essential amino acids or a ketoacid-amino acid mixture and observed closely for clinical complications. Forty-four patients required dialysis. Once dialysis was started, dietary treatment was no longer prescribed. The cumulative mortality rate during the first 2 yr after starting dialysis was 7% (95% confidence interval, 0 to 16%). During this period, only two deaths occurred compared with 11.5 deaths expected on the basis of national mortality rates adjusted for age, sex, race, and cause of renal disease (P = 0.002). However, the protective effect was limited to the first 2 yr on dialysis. Thereafter, mortality rates increased, resulting in a total of 10 deaths during 96.4 person-years of follow-up, which was not significantly lower than the 14.9 deaths expected (P = 0.25). Extrapolation of sequential serum creatinine measurements made before dietary treatment suggests that the improved survival cannot be due to the early initiation of dialysis. Although the lack of an internal control group and data on dialysis lends uncertainty, the large difference in mortality rate between these patients and the nationwide experience indicates that protein restriction and close clinical monitoring predialysis does not worsen and may substantially improve survival during the first 2 yr on dialysis. These findings point out the importance of studying predialysis treatments as a means for lowering mortality on dialysis.

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