title: Is low-protein diet a possible risk factor of malnutrition in chronic kidney disease patients?
abstract: Chronic kidney disease (CKD) is becoming increasingly widespread in the world. Slowing its progression means to prevent uremic complications and improve quality of life of patients. Currently, a low-protein diet (LPD) is one of the tools most used in renal conservative therapy but a possible risk connected to LPD is protein-energy wasting. The aim of this study is evaluate the possible correlation between LPD and malnutrition onset. We enrolled 41 CKD patients, stages IIIb/IV according to K-DIGO guidelines, who followed for 6 weeks a diet with controlled protein intake (recommended dietary allowance 0.7 g per kilogram Ideal Body Weight per day of protein). Our patients showed a significant decrease of serum albumin values after 6 weeks of LDP (T2) compared with baseline values (T0) (P=0.039), whereas C-reactive protein increased significantly (T0 versus T2; P=0.131). From body composition analysis, a significant impairment of fat-free mass percentage at the end of the study was demonstrated (T0 versus T2; P=0.0489), probably related to total body water increase. The muscular mass, body cell mass and body cell mass index are significantly decreased after 6 weeks of LDP (T2). The phase angle is significantly reduced at the end of the study compared with basal values (T0 versus T2; P=0.0001, and T1 versus T2; P=0.0015). This study indicated that LPD slows down the progression of kidney disease but worsens patients' nutritional state.
authors.affiliation: Department of Systems Medicine, Hypertension and Nephrology Unit, University of Rome 'Tor Vergata', Rome, Italy; Haemodyalisis Service, 'Nuova Clinica Annunziatella', Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Noce
authors.affiliation: Department of Biomedicine and Prevention, Division of Clinical Nutrition and Nutrigenomic, University of Rome 'Tor Vergata', Rome, Italy; Nutrition Service, 'Nuova Clinica Annunziatella', Rome, Italy.
authors.forename: M F
authors.initials: MF
authors.lastname: Vidiri
authors.affiliation: Department of Systems Medicine, Hypertension and Nephrology Unit, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Marrone
authors.affiliation: Department of Biomedicine and Prevention, Division of Clinical Nutrition and Nutrigenomic, University of Rome 'Tor Vergata', Rome, Italy; Nutrition Service, 'Nuova Clinica Annunziatella', Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Moriconi
authors.affiliation: Department of Chemical Sciences and Technologies, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bocedi
authors.affiliation: Department of Systems Medicine, Hypertension and Nephrology Unit, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Capria
authors.affiliation: Department of Systems Medicine, Hypertension and Nephrology Unit, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Rovella
authors.affiliation: Department of Chemical Sciences and Technologies, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ricci
authors.affiliation: Department of Biomedicine and Prevention, Division of Clinical Nutrition and Nutrigenomic, University of Rome 'Tor Vergata', Rome, Italy; Nutrition Service, 'Nuova Clinica Annunziatella', Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Lorenzo
authors.affiliation: Department of Systems Medicine, Hypertension and Nephrology Unit, University of Rome 'Tor Vergata' , Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Di Daniele