The kidney disease (nephropathy) can lead to renal failure (end-stage renal disease). a diet low in protein can be recommended in an attempt to slow the progression of renal disease.
monitoring compliance with a restricted diet protein is possible by determining the production of urea, because urea is a by - product of the degradation of the protein. by reducing the production of urea, we limit the accumulation of toxins. the review of studies for people with kidney disease (diabetic kidney disease), it was shown that low protein diets may retard the end-stage renal disease.
the conclusions of the authors.
the reduction of protein intake in patients with chronic nephropathy is renal deaths, 32%, compared with the high protein and the absence of restriction. the optimal level of protein intake can not be confirmed on the basis of these studies.
for more than fifty years, the schemes have been proposed for the low protein in patients with renal impairment. however, the effects of these diets in the prevention of severe renal insufficiency and in need of maintenance dialysis have not been determined.
to determine the effectiveness of low protein systems to delay the need to start dialysis.
studies on the register of the cochrane group kidney, cochrane central register of controlled trials, medline and embase. abstracts of the congress (the american society of nephrology dialysis transplantation since 1990, the association since 1985, international society of nephrology in 1987). direct contacts with researchers.
randomized trials comparing the two different levels of protein intake in adult patients with moderate to severe renal impairment, with a minimum follow-up of one year.
collection and analysis of data.
the two authors selected studies and extracted data independently. statistical analyses were performed using a random effects model and the results were expressed as relative risk (rr) for dichotomous outcomes with confidence intervals (ci) to 95%. reports of deaths, defined as the need for starting kidney dialysis, or death of a patient with a renal transplant during the test.
ten studies were identified from more than 40 studies. a total of 2 000 patients were analyzed, 1 002 were reduced protein intake and a higher protein intake). 281 deaths have been recorded in the renal unit 113 according to the diet low in protein and 168 in the group under more rich in protein (hr 0.68, 95% ci between 0.55 and 0.84, p = 0.0002). in order to avoid renal death, must be between 2 and 56 patients with protein diet for a period of one year.