Effect of dietary protein restriction on the progression of renal failure: a prospective randomized trial.
One hundred twenty-eight patients with different renal diseases and chronic renal failure, stratified according to the underlying disease, were enrolled in a randomized controlled trial to investigate the effects on the rate of decline of renal function of two diets, a controlled protein diet (CPD) of 1 g protein/kg ideal body-weight (i.b.w.)/day, and a low-protein diet (LPD) of 0.6 g protein/kg i.b.w./day, given for 27.1 +/- 21.8 months. Dietary compliance was assessed by a dietary questionnaire, dietary interviews and measurement of 24-h urinary urea excretion. At the end of 6 months, actual mean protein intake was higher than expected (1.06 +/- 0.25 g/kg i.b.w./day) in CPD patients, and (0.80 +/- 0.21 g/kg i.b.w./day) in LPD patients: values were similar at 12 and 18 months after the time of enrollment. The end-point, defined as halving of creatinine clearance, was reached in 40% of patients on CPD, and in 28.6% of those on LPD (P = 0.038 by comparative life-table analysis). Multivariate regression analysis confirmed that CPD was associated with a higher risk of progression than LPD, and that two additional parameters (creatinine clearance at the time of randomization and average proteinuria during the follow-up) were significant independent risk factors, even more important than protein intake.
D'Amico
G
G
Division of Nephrology, San Carlo Borromeo Hospital, Milan, Italy.
Gentile
M G
MG
Fellin
G
G
Manna
G
G
Cofano
F
F
D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D004044:Dietary Proteins