Nutritional considerations in the treatment of patients with chronic uremia.

Low-protein diets ameliorate uremic symptoms and some of its metabolic complications. These diets can be used successfully to treat patients with chronic renal failure (CRF) because they are able to activate normal compensatory responses when protein intake is restricted and their protein and energy requirements are similar to healthy subjects. However, there has been concern that dietary therapy compromises the nutritional status of CRF patients and that initiating dialysis would be preferable to this type of therapy. Kopple and co-workers have identified the requirements of CRF patients for protein and calories and available evidence indicates that when properly implemented, low-protein diets are safe and can maintain lean body mass even during long-term therapy. Based on the information published by Kopple and co-workers, the strategies for treating CRF patients should include careful analysis of the diet and the nutritional status of the patient.