Controlled Comparison of 20-g and 40-g Protein Diets in the Treatment of Chronic Uremia

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Abstract
A controlled comparison was made between 17 patients prescribed a high caloric 20-g protein diet (G) of high biological value and 15 patients fed a more conventional isocaloric 40-g mixed protein diet (P). Although the degree of azotemia decreased significantly only with the G diet, symptomatic and biochemical improvement was similar in both groups. Weight decreased more frequently and bleeding time increased significantly with the G diet. Plasma pH, creatinine clearances, hematocrits, and nerve conduction velocities deteriorated significantly with both diets. Conformity with the diet was evaluated by dietary interviews and analyses of home-prepared diets. While P patients usually adhered to the diet, only 1/17 G patients followed the diet closely for more than a few weeks. Most remained within 30 g of protein; others deviated more. Even those taking greater than 30 g of protein complained; dissatisfaction and overt hostility were common. Enhanced patient acceptance, greater eating pleasure, and similar symptomatic improvement occurred with the more liberal protein intake.