Very low-protein diet to postpone renal failure: Pathophysiology and clinical applications in chronic kidney disease

• Published in: Chronic diseases and translational medicine Vol. 4; no. 1; pp. 45 - 50
• Main Authors: Bellizzi, Vincenzo, Calella, Patrizia, Carrero, Juan Jesus, Fouque, Denis
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.03.2018; Nephrology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno 84131, Italy; European Renal Nutrition e ERN, Working Group at the European Renal Association - European Dialysis Transplant Association e ERA-EDTA%Department of Movement and Wellness Sciences, University of Naples Parthenope, Naples 80133, Italy%European Renal Nutrition e ERN, Working Group at the European Renal Association - European Dialysis Transplant Association e ERA-EDTA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden%European Renal Nutrition e ERN, Working Group at the European Renal Association - European Dialysis Transplant Association e ERA-EDTA; Renal Unit, Universit'e de Lyon, Centre Hospitalier Lyon-SUD, Lyon 69495, France; Chinese Medical Association; Wiley
• Subjects: Chronic kidney disease; Ketoanalogs; Low-protein diet; Medicin och hälsovetenskap; Renal failure; Low-protein diet; Chronic kidney disease; Ketoanalogs; Renal failure
• ISSN: 2095-882X; 2589-0514; 2589-0514
• DOI: 10.1016/j.cdtm.2018.01.003

The uremic syndrome is a metabolic disorder characterized by the impairment of renal handling of several solutes, the resulting accumulation of toxic products and the activation of some adaptive but detrimental mechanisms which all together contribute to the progression of renal damage. In moderate to advanced renal failure, the dietary manipulation of nutrients improves metabolic abnormalities and may contribute to delay the time of dialysis initiation. This commentary focuses on the physiopathological rationale and the clinical application of the very low-protein diet supplemented with ketoanalogs for the management of chronic kidney disease.