The Role of Dietary Protein Restriction in Progressive Azotemia

Abstract
In rats, renal diseases progress to the end stage, but the rate of progression can be slowed dramatically by dietary protein restriction1. In humans, most renal diseases also progress to death due to uremia, unless transplantation or dialysis is provided2. Despite several studies to the contrary, the results of the Modification of Diet in Renal Diseases (MDRD) study, reported in this issue of the Journal by Klahr et al., suggest that the progression of renal diseases in humans is only minimally slowed by dietary protein restriction3. What accounts for these differences?In the studies in rats the . . .