Beneficial Effect of Low Phosphorus Diet in Uraemic Rats: A Reappraisal

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Abstract
1. Diets deficient in phosphorus have been shown to preserve the renal function of uraemic rats, but the role of concomitant alterations in the intake of other nutrients caused by such diets was not elucidated. 2. Five groups of uraemic rats were compared. Three (A, B, C) received (ad libitum) diets deficient (0·03%), low (0·2%) or normal (0·5%) in P. Two groups (D, E) received restricted amounts of 0·2% and 0·5% P diets by pair-feeding with group A rats. 3. Phosphorus deficient diet resulted in marked anorexia, growth arrest, low P and high calcium plasma levels and severe rickets, but renal function became stabilized. Groups B and C had both higher total food intake and weight gain but a significantly higher mortality rate. After 36 weeks, mortality was 90% in these groups, and was 19%, 28% and 44% in groups A, D and E rats respectively, despite a higher P consumption in group E than in group B rats. 4. Normal P diet was associated with severe renal calcium deposits and high calcium heart content, which were related to the degree of hyperparathyroidism evaluated by bone histology. 5. Preservation of renal function was mainly mediated by reduction in some other components of the diet and not by P restriction itself. Normal P diet with restricted dietary allotments had little adverse effect on survival, and its influence on renal histology is not easy to explain. 6. Restriction in P sufficient to cause moderate hypophosphataemia, disappearance of phosphaturia and to prevent hyperparathyroidism without causing anorexia and other severe side effects, had little or no beneficial effect on renal deterioration.