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Deprecated: Implicit conversion from float 284.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+Urol+Nephrol 2016 ; 48 (5): 725-9 Nephropedia Template TP
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Back to the Future: Restricted Protein Intake for Conservative Management of CKD, Triple Goals of Renoprotection, Uremia Mitigation and Nutritional Health #MMPMID26886110
Kovesdy CP; Kalantar-Zadeh K
Int Urol Nephrol 2016[May]; 48 (5): 725-9 PMID26886110show ga
Lowering dietary protein intake (DPI) to approximately 0.6?0.8 g/kgBW/day may be renoprotective through various mechanisms, and it has been recommended in patients with non-dialysis dependent chronic kidney disease (NDD-CKD) as a means to also control various metabolic consequences of advanced CKD, such as uremic symptoms, hyperparathyroidism, hypertension, hyperkalemia and hyperphosphatemia. A meta-analysis in this issue of the Journal suggests that low protein diet is effective and safe when used to retard progression of CKD and alleviate uremic complications. A potential deleterious consequence of lowering DPI in this population is the development or worsening of protein-energy wasting (PEW), which can contribute to poor clinical outcomes such as higher mortality and morbidity. There is currently insufficient high-level evidence to determine the ideal level of DPI in patients with NDD-CKD with risk of PEW. Some have recommended a slightly higher DPI of up to 1 g/kgBW/day as a compromise. Further examination of this dilemma in randomized controlled clinical trials will be necessary.