The Role of Low Protein Diet (LPD) in the Treatment of Chronic Kidney Disease (CKD)
10.2185/jjrm.51.928
- VernacularTitle:慢性腎疾患の治療における低たんぱく食の位置づけ
- Author:
Tatsuo SHIIGAI
;
Yoshitaka MAEDA
;
Takahiko KOBAYASHI
;
Takehito TANASE
;
Kimie KOBAYASHI
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
2003;51(6):928-932
- CountryJapan
- Language:Japanese
-
Abstract:
There is such an opinion that low protein diet (LPD) is unnecessary for preventing progression of renal insufficiency in chronic kidney disease (CKD). However, three randomized control trials of nondiabetic nephropathy (NDN) with CKD, using a metaanalysis method, revealed the usefulness of LPD in preventing progression of renal insufficiency. It is thought that the usefulness of LPD may increase further, if we evaluate randomized control trials one by one and select only what has high quality.
WHO/FAO recommended 0.8 g/kg/day of daily protein intake (DPI) to healthy people from a viewpoint of illness prevention 30 years ago. As, in advanced nations, DPI is 1.1 to 1.3 kg/day/kg in every country, DPI of CKD will become the same level of healthy people if not regulated. It cannot be considered at all that protein restriction is not required for CKD who is more susceptive to cardiovascular diseases than healthy poeple.
In conclusion, we should monitor DPI of patients with CKD, and control DPI between 0.6 and 0.8 g/kg/day. Under the restriction of DPI, we should manage NDN with CKD to prevent progression of renal insufficiency by controlling blood pressure, suppressing rennin-angiotensin system, compensating acidosis and correcting renal anemia.
