ROLE OF HYPOPROTEIC DIET AND ESSENTIAL AMINO-ACIDS IN THE PROGRESSION OF NONDIABETIC CHRONIC RENAL-INSUFFICIENCY

The treatment with low protein diets can decrease the rate of progression of non-diabetic chronic renal failure in humans. To evaluate this finding in our experience, we have studied retrospectively the evolution of renal function in 19 patients (10 males and 9 females) with chronic renal failure during a mean follow-up of 11.44 +/- 6.1 months (ran 2.5-20.3). The initial serum creatinine was 5.8 +/- 1.3 mg/dl. The patients were studied before and after changing conventional diet by hypoproteic diet (20 gr/day) supplemented with essential aminoacids. We have studied 185 medical evaluations, separing clinical and analytical data in pre and post period of diet modification (6.1 +/- 4.9 and 5.2 +/- 3 months, respectively). The average of evaluations was 9.7 +/- 2.1 per patient. We found close lineal correlationship between the inverse of creatinine (serum creatinine-1) and time in 57.9% of patients. We found a significant difference between the mean of the slope between serum creatinine-1 versus time in the pre-diet period and the mean of the same slope during the post-diet period (-0.0048 and 0.3323, respectively; t-test paired, p = 0.027). However, we did not found differences of phosphoremia and serum lipids levels (cholesterol and triglicerides) in both periods. Indeed, the proteinuria and mean blood pressure were similar. Finally, the serum levels of glucose, calcium and alcaline phosphatase were unchanged. The evolution of renal function was not associated with the administration of differents antihypertensives (including converting enzyme inhibitors and calcium-antagonists). We conclude that hypoproteic diet associated with essential aminoacids may retard the progression of non-diabetic chronic renal failure in humans, without side effects and independently of other known factors as control of blood pressure, phosphorus and lipids serum levels.