Refractory body-wasting in the presence of nitrogen retention characterizes the course of the patient with acute or chronic renal failure. Optimal dietary management restricts substances which cannot be excreted from the body but provides essential nutrients to minimize catabolism and promote tissue synthesis and repair. A high-caloric, low-protein diet, which limits the exogenous protein load and takes advantage of the nitrogen sparing effect of carbohydrates, has become an accepted nutrition management for most uremic patients.1 Recently, however, a low-protein, essential amino-acid diet containing 2 to 3 gm nitrogen per day has been used in individuals with severe azotemia. Improvement in the uremic symptoms of nausea, vomiting, fatigue, and muscle irritability occurred in all patients with a concomitant decrease in the blood urea level and attainment of positive nitrogen balance, weight gain, and increases strength and activity.2-4
Use of the selected protein diet in the advanced uremic or surgical patient
Wilmore DW, Dudrick SJ. Treatment of Acute Renal Failure With Intravenous Essential L-Amino Acids. Arch Surg. 1969;99(5):669–673. doi:10.1001/archsurg.1969.01340170121029
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