Neutral Protein
Here are directions to calculate your own value for Neutral Protein. Some have asked if this is a low protein diet. If it is calculated for you specifically then it is a neutral protein diet of 0.6 gm of protein/Kg of body weight. A low protein diet is one that is calculated 0.3 gm of protein per kilogram of body weight. Do not undertake this unless you are very near dialysis. It must be supplemented with Essential Amino Acids formulated for kidney patients by Calwood Pharmaceuticals. Dr. MacKenzie Walser has written a book, Coping with Kidney Disease. This outlines his recommendations. You will need the help of a nephrologist. Care will need to be taken that your serum albumin level stays within normal limits. The animo acid leucine is particularly important to maintain this while on dialysis.
China Study
The China Study was written by a scientist, T. Colin Campbell who went to third world countries to convince them to have their children eat more protein. He studied in particular children in the Philippines. These children came from the wealthier families. They ate the most protein because they could afford to eat more proteins but these children were dying of liver cancer at a very young age. Liver cancer is usually a disease of an older population. There was coincidentally a little publicized study going on at the same time. Researchers fed rats a known amount of aflatoxin [known to be in peanuts]. They divided the rats into two groups. One group ate a lower protein diet; the second group ate a high protein diet. 100% of the high protein diet rats ALL developed liver cancers and died. 0% of the low protein diet rats did not develop liver cancer. Both groups received the exact same dose of the carcinogen aflatoxin. He makes an interesting point about vegetarian.Low Protein
Researchers assigned 56 patients to a vegan diet. Another 56 were started on dialysis.
The two groups had equal results.
Very low protein diet delays dialysis in the elderly.
Wednesday, May. 23, 2007
NEW YORK (Reuters Health) - In elderly non-diabetic people with failing kidneys, a supplemented very-low-protein diet can be safely used to postpone the start of dialysis, according to a report from Italy.
"Imagine that? 25 percent of elderly patients ... could be treated with this diet, a tremendous amount of money can be saved," Dr. Giuliano Brunori, from Spedali Civili di
Brescia, told Reuters Health.
Brunori and his colleagues investigated the safety and efficacy of a very-low-protein diet in decreasing the symptoms of kidney failure and postponing the start of
dialysis in patients 70 years of age or older with chronic kidney disease that had progressed to the point where they would normally start dialysis.The researchers
assigned 56 patients to the diet, and another 56 were started on dialysis. The intervention diet was vegan-based, with no more than 0.3 grams of protein per
kilogram of body weight daily, but supplemented with essential amino acids and vitamins.
Over the next two years, 40 of the very-low-protein diet-treated patients had to begin dialysis therapy, but it was delayed by an average of 9.8 months after
beginning the diet, the authors report in the American Journal of Kidney Diseases. One-year survival rates did not differ significantly between the dialysis and
diet groups, at 83.7 percent and 87.3 percent, respectively.
The very-low-protein-diet group had significantly fewer hospitalizations and days of hospitalization than did the dialysis group, the researchers note, even after
adjustment for differences in age. In normal elderly kidney patients without a lot of other health problems, "the diet does not induce malnutrition and is not
life-threatening," Brunori said. "Hospitalization is lower and patients' and families' burdens can be reduced."
"Furthermore," Brunori added, "we want to verify the feasibility of this diet in patients younger than 70."
Some Articles
Brunori G [Author]
Institute and Department of Nephrology, University and Spedali Civili of Brescia, Brescia, Italy. gcbrunori@hotmail.com
Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study.
2008. A very low protein diet (0.3 grams/kg) was effective and safe when postponing dialysis treatment in elderly patients without diabetes
Very low protein diet delays dialysis in elderly
2007. Imagining that 25 percent of elderly patients ... could be treated with this diet, a tremendous amount of money can be saved," Dr. Giuliano Brunori, from Spedali Civili di Brescia, told Reuters Health.
How to manage elderly patients with chronic renal failure: conservative management versus dialysis
2007. The first study demonstrated that, although dialysis is generally associated with longer survival in patients aged >75 years, those with multiple comorbidities, ischemic heart disease in particular, do not survive longer than those treated conservatively. The second one is a randomized controlled study that compared a sVLPD with dialysis in 112 non-diabetic patients aged greater than 70 years. Survival was not different between the two groups and the number of hospitalizations and days spent in hospital were significantly lower in those on a sVLPD.
Diet or dialysis in the elderly? The DODE study: a prospective randomized multicenter trial.
2000. very-low-protein diet (VLPD) supplemented with essential amino acids and keto-analogs of amino acids, and with an adequate quantity of calories, can prevent hypoalbuminemia at the start of dialysis and can slow the progression of chronic renal failure.
A review of albumin binding in CKD
Am J Kidney Dis. 2008 May Hypoalbuminemia is associated with excess mortality in patients with kidney disease.
Are supplemented low-protein diets nutritionally safe?
2001. Over 15 years, 239 patients were treated with a very-low-protein diet providing 0.3 g vegetable protein/kg/day supplemented (SLPD) with essential amino acids and keto analogs. Many adverse consequences of uremia were corrected by this regimen, such as metabolic acidosis, secondary hyperparathyroidism, resistance to insulin, decreased Na(+)-K(+)-ATPase activity
Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet
2000. The results of the study reduced serum urea levels correcting several metabolic disorders alleviated uremic symptoms and delayed the onset of end stage renal failure treatment until GFR levels lower than those currently recommended were attained
Dietary amino acids enhance allograft survival
1999. Dr. Valente
Amino acid workshop paper on cystine harm.
2006
Antioxidant effects of a supplemented very low protein diet in chronic renal failure.
1997
