North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease

Kamyar Kalantar-Zadeh, Linda W. Moore, Amanda R. Tortorici, Jason A. Chou, David E. St-Jules, Arianna Aoun, Vanessa Rojas-Bautista, Annelle K. Tschida, Connie M. Rhee, Anuja A. Shah, Susan Crowley, Joseph A. Vassalotti, Csaba Kovesdy

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Whereas in many parts of the world a low protein diet (LPD, 0.6-0.8 g/kg/day) is routinely prescribed for the management of patients with non-dialysis-dependent chronic kidney disease (CKD), this practice is infrequent in North America. The historical underpinnings related to LPD in the USA including the non-conclusive results of the Modification of Diet in Renal Disease Study may have played a role. Overall trends to initiate dialysis earlier in the course of CKD in the US allowed less time for LPD prescription. The usual dietary intake in the US includes high dietary protein content, which is in sharp contradistinction to that of a LPD. The fear of engendering or worsening protein-energy wasting may be an important handicap as suggested by a pilot survey of US nephrologists; nevertheless, there is also potential interest and enthusiasm in gaining further insight regarding LPD's utility in both research and in practice. Racial/ethnic disparities in the US and patients' adherence are additional challenges. Adherence should be monitored by well-trained dietitians by means of both dietary assessment techniques and 24-h urine collections to estimate dietary protein intake using urinary urea nitrogen (UUN). While keto-analogues are not currently available in the USA, there are other oral nutritional supplements for the provision of high-biologic-value proteins along with dietary energy intake of 30-35 Cal/kg/day available. Different treatment strategies related to dietary intake may help circumvent the protein- energy wasting apprehension and offer novel conservative approaches for CKD management in North America.

Original languageEnglish (US)
Article number90
JournalBMC Nephrology
Volume17
Issue number1
DOIs
StatePublished - Jul 19 2016

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Protein-Restricted Diet
Chronic Renal Insufficiency
Dietary Proteins
North America
Diet Therapy
Urine Specimen Collection
Proteins
Nutritionists
Patient Compliance
Disease Management
Energy Intake
Biological Products
Fear
Prescriptions
Urea
Dialysis
Nitrogen
Kidney
Research
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Kalantar-Zadeh, K., Moore, L. W., Tortorici, A. R., Chou, J. A., St-Jules, D. E., Aoun, A., ... Kovesdy, C. (2016). North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease. BMC Nephrology, 17(1), [90]. https://doi.org/10.1186/s12882-016-0304-9

North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease. / Kalantar-Zadeh, Kamyar; Moore, Linda W.; Tortorici, Amanda R.; Chou, Jason A.; St-Jules, David E.; Aoun, Arianna; Rojas-Bautista, Vanessa; Tschida, Annelle K.; Rhee, Connie M.; Shah, Anuja A.; Crowley, Susan; Vassalotti, Joseph A.; Kovesdy, Csaba.

In: BMC Nephrology, Vol. 17, No. 1, 90, 19.07.2016.

Research output: Contribution to journalArticle

Kalantar-Zadeh, K, Moore, LW, Tortorici, AR, Chou, JA, St-Jules, DE, Aoun, A, Rojas-Bautista, V, Tschida, AK, Rhee, CM, Shah, AA, Crowley, S, Vassalotti, JA & Kovesdy, C 2016, 'North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease', BMC Nephrology, vol. 17, no. 1, 90. https://doi.org/10.1186/s12882-016-0304-9
Kalantar-Zadeh K, Moore LW, Tortorici AR, Chou JA, St-Jules DE, Aoun A et al. North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease. BMC Nephrology. 2016 Jul 19;17(1). 90. https://doi.org/10.1186/s12882-016-0304-9
Kalantar-Zadeh, Kamyar ; Moore, Linda W. ; Tortorici, Amanda R. ; Chou, Jason A. ; St-Jules, David E. ; Aoun, Arianna ; Rojas-Bautista, Vanessa ; Tschida, Annelle K. ; Rhee, Connie M. ; Shah, Anuja A. ; Crowley, Susan ; Vassalotti, Joseph A. ; Kovesdy, Csaba. / North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease. In: BMC Nephrology. 2016 ; Vol. 17, No. 1.
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