Efficacy of an unselected protein diet (25 g) with minor oral supply of essential amino acids and keto analogues compared with a selective protein diet (40 g) in chronic renal failure

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Abstract
The efficacy of a mixed protein-poor diet (25 g) with an intake of only 12 tablets of essential amino acids or keto analogues (= 0.9 Rose units) was compared with that of a selective protein diet (40 g). Twenty-eight patients with chronic renal insufficiency (creatinine clearance 13.2 ± 5.6 ml/min per 1.73 m2) were included in the prospective study with four periods of 3 months each. Each patient served as his own control. The mixed protein-poor diet showed a better patient compliance irrespective of the type of supplement. In addition, the essential amino acid supplementations showed no advantages over the standard diet. In patients with a creatinine clearance less than 10 ml/min, the keto analogue supplementation led to an improvement of the uremic intoxication and the nutritional state. An increase in renal function was not observed. The phosphate decrease occurred even when there were signs of protein malnutrition.