THE EFFECTS OF LOW PROTEIN DIET ON NUTRITIONAL AND BONE STATES AND PROGRESSION RATE IN CHRONIC RENAL FAILURE

In this study we assesed the influence of low protein diet (LPD) and very low protein diet (VLPD) plus ketosteril tablets on the nutritional and the bone status in chronic renal failure and also on its progression. Ten patients (M/F= 5/5, mean age= 45.2±22.3 years) with CRF were enrolled into the study. The nutritional status assesed from anthropometric measurements such as body mass index (BMl) and triceps skin fold thickness (TSF), from biochemical measurements such as serum albumin, transferrin, total cholesterol and triglyceride levels. The serum levels of calcium, phosphorous and intact patrathyroid hormone (iPTH) were determined to evaluate the bone status. The progression of renal failure was assesed from creatinine clearence (CCR).

All patients were started with LPD containing 0.6 gr/kg/day protein and an energy intake of 35 kcal/kg/day. They were followed for 6 months. At the end of this period the diet was changed to VLPD containing 0.4 gr/kg/day plus ketosteril tablets (1 tablet/5 kgs) and an energy intake of 35 kcal/day. Patients were followed for another 6 months (secondperiod). The initial measurements done were repeated at the end of each period.

Paired-sample t-test, two-way Annova test and multiple regression analysis were used as statistical methods. There was no significant difference between the initial, end of first period and end of second period mean values of the parameters studied. The effects of different diets on nutritional parameters, parameters showing bone status and CCR did not differ significantly from each other. CCR was negatively correlated with serum albumin (r=0.12) and transferrin levels (r=0.23) but these correlations were statistically insignificant.