[Relationship between low-protein diet and hypertension control].

Arterial hypertension is found in almost all patients with chronic kidney disease. The US Kidney Foundation guidelines recommend a pressure target for chronic kidney disease patients (130/80 mmHg) that may be difficult to reach because of the reduced sodium excretion in these patients and the widespread use of vasodilator drugs. Reducing the dietary protein intake may help to lower the dietary sodium load. The 130/80 mmHg target has been reached in 30% of stage 4 and 5 patients only after six months of a very low-protein diet supplemented with keto-analogues and essential amino acids. However, even moderate reductions of dietary sodium intake are useful in patients with compromised renal function, as was shown by Koomans et al more than 20 years ago. Blood pressure levels are lower in vegetarians, possibly also because of the reduced sodium content of potassium-rich vegetarian diets. Diets rich in unrefined cereals, vegetables, fruit and low-fat cheese may be useful in patients with chronic kidney disease. Commercial low-protein preparations may help to design diets that are both low in sodium, potassium and phosphorus and adequate for caloric needs.