title: Kidney protection: how to prevent or delay chronic renal failure.
abstract: In patients at risk for chronic renal failure, early clinical interventions have been shown to prevent or delay progression of the disease. A low-protein diet is recommended when the serum creatinine is between 1.5 and 2.5 mg/dl. Benefit from protein restriction can only be achieved if energy intake is greater than 35 kcal/kg/d. To preserve skeletal muscle, correct metabolic acidosis with oral sodium bicarbonate supplementation. For hypertension control and renal protection, start ACE inhibitors when serum creatinine is less than 2 mg/dl. Correct anemia with erythropoietin to improve or maintain quality of life when the hematocrit falls below 30%. For the diabetic, ACE inhibitors and glycemic control have been shown to show the rate of renal failure.
authors.affiliation: Dialysis unit, Beth Israel Hospital, Boston, USA.
authors.forename: T I
authors.initials: TI
authors.lastname: Steinman
mesh_terms: D000740:Anemia / Q000188:drug therapy; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000517:prevention & control*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004044:Dietary Proteins; D003404:Creatinine