The Effect of Caloric Intake on Nitrogen Balance in Chronic Renal Failure

Hyne, B. E. B.; Fowell, E.; Lee, H. A.

doi:10.1042/cs0430679

Cited by 48 publications

(10 citation statements)

References 8 publications

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“…All methods for sample collecting and analysis were according to those of Hyne et al (1972), and the nitrogen balances were corrected as described by them. The constituents of the amino acid tablets used (Kidnamin, Vitrum, supplied by Paines and Byrne Ltd., Green-ford, England) and how the requirements for a patient were calculated are shown in table I.…”

Section: Methodsmentioning

confidence: 99%

“…Basic protein requirements for such regimes vary from as little as 0.25 g (40 mg nitrogen)/kg body weight/day (Shaw et al, 1965) to 0.5 g (80 mg nitrogen)/kg body weight/day (Ford et al, 1969). Recently Hyne et al (1972) have suggested a range of 45-50 mg of nitrogen/kg body weight as a more realistic figure provided that adequate caloric intake is ensured.…”

mentioning

confidence: 99%

“…Hyne et al (1972) have shown that the optimum improvement in nitrogen balance in chron ic renal failure patients on low protein diets is achieved with a caloric intake of 55 cal/kg body weight/day.…”

mentioning

confidence: 99%

“…Shaw et al (1965) and Hyne et al (1972) have recommended that a high proportion of high biological value protein should be used whereas Ford et al (1969) have suggested that the biological value of the protein is of little impor tance. However, recent work by Kofranyi et al (1970) may lead to further revision of the type of protein used in the design of these diets.…”

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confidence: 99%

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Amino Acid Tablet-Substituted Diets in the Management of Chronic Renal Failure

et al. 1974

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Low protein Giovannetti diets in three patients with chronic renal failure have been compared with isonitrogenous, iso-caloric amino acid tablet-substituted regimes. Another patient has been managed on such a regime after regular haemodialysis treatment had to be suspended. The amino acid diets proved palatable and were effective in maintaining nitrogen balance when the caloric supply was adequate. Improved nitrogen balance correlated with diminished faecal nitrogen excretion and falling or stable blood urea levels implying improved urea nitrogen re-utilization. It is suggested that when the caloric supply is adequate for generation of sufficient α-ketonic acid derivatives, ammonia nitrogen is preferentially utilized for the synthesis of non-essential amino acids rather than more urea formation. Metabolic acidosis is a potential hazard of such regimes.

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Section: Methodsmentioning

confidence: 99%

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Amino Acid Tablet-Substituted Diets in the Management of Chronic Renal Failure

et al. 1974

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“…However, no GFR slope data was available making it impossible to separate the effect of dietary protein (0.25 to 0.30 g/kg/d), an increase in energy intake up to 55 kcal/kg/d is unable to restore neutral delay in dialysis secondary to symptom control, from that arising out of preservation of GFR. Pedrnini et al balance [25]. Additionally, in the presence of metabolic acidosis, patients with chronic renal failure are unable presented a meta-analysis of 1,413 patients with nondiabetic renal disease from five RCTs (mean length of follow-to activate the compensatory mechanisms to adapt to a low protein diet, despite an adequate energy intake [26].…”

Section: Lpd and Preservation Of Gfrmentioning

confidence: 99%

Low Protein Diets Are Not Needed in Chronic Renal Failure

Mehrotra

Nolph

1999

Mineral Electrolyte Metab

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Low protein diets have been used for a long time in the conservative management of chronic renal failure as they have a beneficial effect in preventing the appearance of symptoms. However, with the exception of the beneficial effect on hyperphosphatemia of the very low protein diets supplemented with ketoacids, they have no proven effects on the other aspects of the uremic syndrome. Moreover, the weight of the evidence suggests that the effect of these diets on preservation of GFR, if any, in patients with nondiabetic renal disease is small and of little clinical relevance. There is very little evidence in the literature of its role in patients with diabetes. The nutritional safety of these diets is still suspect. Patients with chronic renal failure have low energy intakes, which is further reduced when these diets are prescribed. Metabolic studies predict that these patients would be in negative nitrogen balance and in fact, even nutritionally sound, nondiabetic patients enrolled in the Modification of Diet in Renal Disease Study developed subclinical signs of malnutrition. It is possible that the nutritional decline may have been more pronounced on longer duration of follow-up. Finally, these diets are difficult to follow, leading to issues of compliance and exert a great toll on the time of the dietitians. Hence, we conclude that low protein diets are not necessary in chronic renal failure.

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