Metabolic Effects of a Very-Low-Protein, Low-Phosphorus Diet Supplemented with Essential Amino Acids and Keto Analogues in End-Stage Renal Diseases

Ciardella, F; Morelli, Ester; Cupisti, Adamasco; Christu, C; Mazzotta, L; Casto, G; Carbone, Carla; Niosi, F; Petronio, Mg; Barsotti, Giovanni

doi:10.1159/000415750

Cited by 5 publications

(3 citation statements)

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“…Very little is known about these aspects of protein-reduced diets. Studies that have examined the issue and reported declines in serum triglyceride and cholesterol have not controlled the important variable of calorie intake (8)(9)(10). Regardless of the direction of change in lipid concentrations, more subtle differences in lipoprotein structure, synthesis, and clearance rates may still affect atherogenesis.…”

Section: What Are Risks Of Dietary Protein Restriction In Diabetic Pamentioning

confidence: 99%

Safety of Low-Protein Diets: Where's the Beef?

Brodsky

Robbins

1989

Diabetes Care

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The earliest signs of renal impairment in the diabetic patient traditionally marked the onset of an era of frustration for both physician and patient. Aside from meticulous control of hypertension, there was little to do to alter the inexorable course to dialysis or transplantation. However, if the recent reports touting the benefits of low-protein diets are correct, all of this may soon change; these diets may delay or prevent end-stage renal insufficiency. The question is whether these diets are safe as well as efficacious.The diabetic patient is of special concern. These diets will be superimposed on existing abnormalities in insulin-mediated processes. Even subtle changes in substrate metabolism can be expected to have a profound cumulative impact over years of treatment. Our ability to detect evidence of early nephropathy makes it tempting to apply this therapy for relatively long periods.Low-protein diets, as they are currently formulated, are composed of unstandardized and variable combinations of carbohydrate (CHO), fat, and protein. There is no agreement on the degree of protein reduction or optimum ratios of complex to simple CHO, unsaturated to saturated fat, and biologically high-quality to lowquality protein. Thus, whereas these diets may be the Creatinine 1 (JLM = 0.011 mg/dlCreatinine clearance 1 ml/s = 60 ml/min

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Section: What Are Risks Of Dietary Protein Restriction In Diabetic Pamentioning

confidence: 99%

Safety of Low-Protein Diets: Where's the Beef?

Brodsky

Robbins

1989

Diabetes Care

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“…The relationship between dietary protein restriction and non‐diabetic renal failure progression has been examined by four meta‐analyses, 9–12 16 randomised controlled trials, 6,8 , 13–29 one prospective double‐blind cross‐over study, 30 10 prospective controlled trials, 31–40 16 prospective non‐controlled trials 22,22 , 41–56 and six retrospective observational cohort studies 44,57–61 . The largest and best‐designed randomised controlled trial to date was the Modification of Diet in Renal Disease (MDRD) study 6 .…”

Section: The Clinical Evidence That Dietary Protein Restriction Retarmentioning

confidence: 99%

Dietary protein restriction as a treatment for slowing chronic kidney disease progression: The case against (Review Article)

Johnson

2006

Nephrology

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“…The relationship between dietary protein restriction and non‐diabetic renal failure progression has been examined by 4 meta‐analyses, 1–4 11 randomised controlled trials (RCTs), 5–12 1 prospective double‐blind cross‐over study, 13 8 prospective controlled trials, 14–21 13 prospective non‐controlled trials, 22–34 and 7 retrospective observational cohort studies 35–40 . In view of the potential for serious bias in the non‐randomised studies, this review will be restricted to the RCTs and meta‐analyses.…”

Section: What Is the Evidence?mentioning

confidence: 99%