Importance of Early Initiation of Dietary Protein Restriction for the Prevention of Experimental Progressive Renal Disease

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Abstract
The effect of dietary protein restriction on the progress of renal dysfunction was investigated in rats with adriamycin (ADR)-induced progressive glomerular disease. Dietary protein was reduced from 20% (normal diet) to 5% (low protein) immediately after (ADR-0w), 8 weeks (ADR-8w) or 16 weeks (ADR-16w) after the repeated injection of ADR. In the unrestricted (ADR-UR) group rats were fed 20% of protein throughout the 24-week experiment. Massive urinary protein developed immediately after ADR injection and significantly decreased by reducing dietary protein in all the groups (ADR-0w, ADR-8w, ADR-16w). However, plasma protein and serum albumin were low irrespective of the improvement of urinary protein. BUN and serum creatinine were unchanged in ADR-0w and ADR-8w groups, while they were increased in ADR-16w and ADR-UR groups. Glomerular sclerosis and tubular atrophy were much less severe in ADR-0w and ADR-8w than in ADR- 16w and ADR-UR groups. The results indicate that dietary protein restriction checks the further progress of renal dysfunction. The importance of the time when protein intake should be reduced is discussed.