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.

Our hospital has a nutrition support team (NST) serving inpatients of all department. Two years ago, the team started activities with the motto “Apt nutritional management for inpatients”. It is an interdepartmental unit consisting of physicians, nurses, dietitians, pharmacists and speech therapists. Initially we found it difficult to make time to join forces, but now it has become possible to screen patients for undernourishment on a weekly basis while making nutritional assessment and planning, and holding consultations. The main purpose of the consultations is to improve the nutritional status of patients according to plans formulated after nutritional assessment made at the request of physicians and nurses in charge of the patients. To achieve the objective, we are expected to concentrate all our efforts and brains. This paper presents some consultation cases we have handled. In addition, the nutritional assessment and nutritional intervention activities of our hospital are described.
Nutrition Assessment ; Nutritional status ; Nutritional Support ; Hospitals ; Consultation

Objective: In this study, we evaluated distinctive types of physical predisposition in patients with common side effects.
Method: We selected 500 and 1,200 individuals with and without a previous diagnosis of side effects, respectively, through web-based research.  Then, we conducted a decision tree analysis for investigating the status of 100 types of physical predisposition in these individuals.
Results and Conclusion: The individuals who had suffered from hepatic disorder and answered “relevant” for “predisposition to swelling” (likelihood ratio of a positive result [LR+] 2.17; p=0.004) and “very relevant” for “predisposition to skin dryness” (LR+ 3.52; p<0.001) enhanced the probability of extracting individuals who developed side effects.  The individuals who had suffered from skin disorder and answered “relevant” for “predisposition to eczema and inflammation” and “not relevant” for “predisposition to higher temperature” had an LR+ of 2.22 (p<0.001).  The individuals with “predisposition to worsening of physical condition on a rainy or high-humidity day” are more likely to develop side effects with the use of antibiotics and NSAIDs, compared to those without this predisposition (antibiotics: LR+ 2.33; NSAIDs: LR+ 2.51).  The results of this study indicate that we can identify patients with a high risk of side effects through an interview on predisposition.