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