The conservative management of chronic renal failure: Results of a recent survey

Abstract

Opinions differ regarding the role of protein restriction in the progression of renal disease. Unfortunately the Modification of Diet in Renal Disease Study did not settle this controversy. To assess the use of low protein diets (LPDs) in the United Kingdom, renal dietitians were surveyed about the current dietetic practices and beliefs in their Renal Units. In the survey, 81% of questionnaires were returned (59 of 73), of these 35 Renal Units were using LPDs (<1 g/kg body weight). The majority (33) used LPDs for symptomatic relief and 20 for slowing progression. The use of LPDs in diabetic patients was similar to nondiabetic patients, but LPDs were started earlier by 12 Renal Units. Most (22) of the dietitians calculate LPDs on the basis of ideal body weight. Nutritional assessment was by weight (35), body mass index (26), serum albumin (31), and upper arm anthropometry (10). The lack of agreement, both within and outside of Renal Units will ensure that the debate regarding protein restriction continues.