Nutritional Considerations in the Treatment of Patients with Chronic Uremia
Abstract
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 hade 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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
High-protein diets are poorly tolerated by people with chronic renal disease and markedly reduced glomerular filtration rate; excess protein raises phosphorus load, which can cause acidosis and worsen insulin resistance.
“Highprotein diets of any sort are not well tolerated by individuals with chronic renal disease who have markedly reduced glomerular filtration rate; excess protein enhances phosphorus load, which can cause acidosis and worsen insulin resistance.155,156”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [155]
Cites
Energy and protein requirements*
Pacey, A., & Payne, P. (2019) · Routledge eBooks · doi:10.4324/9780429036279-4 · Cited by 2,545 · see citing works
Lowrie, E. G., & Lew, N. L. (1990) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(12)70364-5 · Cited by 1,986 · see citing works
Mechanisms of Muscle Wasting — The Role of the Ubiquitin–Proteasome Pathway
Mitch, W. E., & Goldberg, A. L. (1996) · New England Journal of Medicine · doi:10.1056/nejm199612193352507 · Cited by 1,163 · see citing works
Self-citationA method for estimating nitrogen intake of patients with chronic renal failure
Maroni, B. J., Steinman, T. I., & Mitch, W. E. (1985) · Kidney International · doi:10.1038/ki.1985.10 · Cited by 789 · see citing works
Self-citationBailey, J. L., Wang, X., England, B. K., Price, S. R., Ding, X., & Mitch, W. E. (1996) · Journal of Clinical Investigation · doi:10.1172/jci118566 · Cited by 455 · see citing works
Self-citationSpontaneous dietary protein intake during progression of chronic renal failure.
Ikizler, T. A., Greene, J. H., Wingard, R. L., Parker, R. A., & Hakim, R. M. (1995) · Journal of the American Society of Nephrology · doi:10.1681/asn.v651386 · Cited by 395 · see citing works
Ballmer, P. E., McNurlan, M. A., Hulter, H. N., Anderson, S. E., Garlick, P. J., & Krapf, R. (1995) · Journal of Clinical Investigation · doi:10.1172/jci117668 · Cited by 370 · see citing works
Levey, A. S., Adler, S., Caggiula, A. W., England, B. K., Greene, T., Hunsicker, L. G., Kusek, J. W., Rogers, N. L., & Teschan, P. E. (1996) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(96)90099-2 · Cited by 334 · see citing works
USE OF EXOGENOUS AND ENDOGENOUS UREA FOR PROTEIN SYNTHESIS IN NORMAL AND UREMIC SUBJECTS.
Giordano, C. (1963) · PubMed · Cited by 301 · see citing works
Mechanisms of hypoalbuminemia in hemodialysis patients
Kaysen, G. A., Rathore, V., Shearer, G. C., & Depner, T. A. (1995) · Kidney International · doi:10.1038/ki.1995.321 · Cited by 295 · see citing works
Hakim, R. M., & Lazarus, J. M. (1995) · Journal of the American Society of Nephrology · doi:10.1681/asn.v651319 · Cited by 273 · see citing works
Kopple, J. D., Levey, A. S., Greene, T., Chumlea, W. C., Gassman, J. J., Hollinger, D. L., Maroni, B. J., Merrill, D., Scherch, L. K., Schulman, G., et al. (1997) · Kidney International · doi:10.1038/ki.1997.395 · Cited by 219 · see citing works
Self-citationEffect of dietary protein intake on albumin homeostasis in nephrotic patients
Kaysen, G. A., Gambertoglio, J. G., Jimenez, I., Jones, H. B., & Hutchison, F. N. (1986) · Kidney International · doi:10.1038/ki.1986.36 · Cited by 210 · see citing works
Correction of acidosis in humans with CRF decreases protein degradation and amino acid oxidation
Reaich, D., Channon, S. M., Scrimgeour, C. M., Daley, S. E., Wilkinson, R., & Goodship, T. H. J. (1993) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1993.265.2.e230 · Cited by 209 · see citing works
Acidosis, not azotemia, stimulates branched-chain, amino acid catabolism in uremic rats
Hara, Y., May, R. C., Kelly, R. A., et al. (1987) · Kidney International · doi:10.1038/ki.1987.280 · Cited by 185 · see citing works
Ammonium chloride-induced acidosis increases protein breakdown and amino acid oxidation in humans
Reaich, D., Channon, S. M., Scrimgeour, C. M., & Goodship, T. H. J. (1992) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1992.263.4.e735 · Cited by 171 · see citing works
Why are dialysis patients malnourished?
Bergström, J. (1995) · American Journal of Kidney Diseases · doi:10.1016/0272-6386(95)90178-7 · Cited by 169 · see citing works
Energy expenditure in patients with chronic renal failure
Monteón, F., Laidlaw, S. A., Shaib, J. K., & Kopple, J. D. (1986) · Kidney International · doi:10.1038/ki.1986.250 · Cited by 156 · see citing works
Metabolic acidosis and skeletal muscle adaptation to low protein diets in chronic uremia
Williams, B., Hattersley, J., Layward, E., et al. (1991) · Kidney International · doi:10.1038/ki.1991.275 · Cited by 135 · see citing works
Adaptation to low-protein diets in renal failure
Goodship, T. H. J., Mitch, W. E., Hoerr, R., Wagner, D. A., Steinman, T. I., & Young, V. R. (1990) · Journal of the American Society of Nephrology · doi:10.1681/asn.v1166 · Cited by 132 · see citing works
Self-citationLong-term adaptive responses to dietary protein restriction in chronic renal failure
Tom, K., Young, V. R., Chapman, T. E., Masud, T., Akpele, L., & Maroni, B. J. (1995) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1995.268.4.e668 · Cited by 106 · see citing works
Self-citationMechanisms of hypoalbuminemia in hemodialysis patients (Kidney International 48: (510-516))
Kaysen, G. A., Rathore, V., Shearer, G. C., & Depner, T. A. (1995) · Kidney International · Cited by 95 · see citing works
Maroni, B. J., Staffeld, C., Young, V. R., Manatunga, A. K., & Tom, K. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119432 · Cited by 83 · see citing works
Self-citationCoresh, J., Walser, M., & Hill, S. B. (1995) · Journal of the American Society of Nephrology · doi:10.1681/asn.v651379 · Cited by 83 · see citing works
Walser, M. (1993) · Kidney International · doi:10.1038/ki.1993.360 · Cited by 75 · see citing works
Treatment of nephrotic adults with a supplemented, very low-protein diet
Walser, M., Hill, S. B., & Tomalis, E. A. (1996) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(96)90492-8 · Cited by 51 · see citing works
ROLE OF NUTRITION IN PREVENTION OF THE PROGRESSION OF RENAL DISEASE
Maroni, B. J., & Mitch, W. E. (1997) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.17.1.435 · Cited by 46 · see citing works
Self-citationRequirements for protein, calories, and fat in the predialysis patient.
Masud, T., Mitch, W. E., & Ikizler, T. A. (2010) · Cited by 32 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961 · see citing works
- Authors
- Mitch, W. E., & Maroni, B. J.
- Affiliations
- Emory University (US)
- Venue
- Mineral and Electrolyte Metabolism
- Publisher
- S. Karger AG
- Published
- 1998
- Volume
- 24
- Issue
- 4
- Pages
- 285-289
- ISSN
- 0378-0392 (ISSN-L)
- 1423-016X
- OpenAlex
- W2038118455
- Cited by
- 17
- References
- 28
- Citations by year
- 2015: 1 · 2014: 1 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mineral and Electrolyte Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- chronic kidney disease, uremia, low-protein diet, nutritional status, protein requirements, energy requirements, lean body mass, dietary therapy, dialysis
- MeSH terms
- Humans, Kidney Failure, Chronic, Nutritional Physiological Phenomena, Nutritional Requirements, Nutritional Status, Risk Factors, Uremia, Diet, Protein-Restricted
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
