Is There a Role for Protein Restriction in the Treatment of Chronic Renal Failure?

Rationale for Protein Restriction in Renal Failure The rationale for protein restriction is very simple: since the kidneys have the major responsibility for removing the waste products of protein metabolism, these products accumulate in patients with chronic renal failure and are the direct cause of most of the signs and symptoms, even though the quantitative relationship between these signs and symptoms and the level of these accumulated metabolites is variable. Obviously a high protein intake will thus aggravate these signs and symptoms, while a low protein diet will ameliorate them. But protein restriction can clearly be overdone. If the intake of essential amino acids is less than the subject’s requirements, progressive protein malnutrition will slowly develop. It follows logically that a diet completely free of whole protein, but supplemented by essential amino acids as such, will be optimal for reducing signs and symptoms. Rose and associates, in their classic studies, had established that normal subjects need no protein at all and only small amounts of nonessential N to maintain N balance on a diet supplemented by essential amino acids [1].