title: Adaptive response to a low-protein diet in predialysis chronic renal failure patients.
abstract: Arandomized, controlled study of 12 patients with mild chronic renal failure was designed to assess the metabolic effects of a low-protein diet supplemented (n = 6) or not (n = 6) with ketoanalogs of amino acids. The protein intake was prescribed so that both groups were isonitrogenous. The dietary survey each month included a 3-d food record and a 24-h urine collection for urea measurement. After a 4- to 6-wk equilibrium period (standard occidental diet, 1.11 g of protein and 32 kcal/kg per d), patients reduced their protein intake to reach 0.71 g of protein/kg per d during the third month. Energy intake was kept constant (31 kcal/kg per d) during the 3-mo period. Compliance to the diet was achieved after 2 mo of training. Leucine turnover measurement was performed before and at the end of the 3-mo low-protein period. There was no clinical change, whereas total body flux decreased by 8% (P < 0.05) and leucine oxidation by 18% (P < 0.05). No difference could be attributed to the ketoanalogs themselves. Thus, under sufficient energy intake, a low-protein diet is nutritionally and metabolically safe during chronic renal failure. The nitrogen-sparing effect of a low-protein diet is still present during mild chronic renal insufficiency.
authors.affiliation: Department of Nephrology and Renal Nutrition, Hospital Edouard Herriot, Lyon, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Bernhard
authors.affiliation: Laboratoire de Nutrition Humaine, Clermont-Ferrand, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Beaufrère
authors.affiliation: Department of Nephrology and Renal Nutrition, Hospital Edouard Herriot, Lyon, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Laville
authors.affiliation: Department of Nephrology and Renal Nutrition, Hospital Edouard Herriot, Lyon, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000596:Amino Acids / Q000008:administration & dosage* / Q000097:blood; D001823:Body Composition; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage / Q000097:blood; D002149:Energy Intake; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy* / Q000378:metabolism; D007930:Leucine / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D000596:Amino Acids; D004044:Dietary Proteins; D007930:Leucine