Amino acid supplemented diet vs. selective low protein diet in chronic renal failure.

Two groups of patients with chronic renal failure (creatinine clearance 13 ml/min) were treated with two different low protein diets: unselected protein diet with 0.35 g of protein/kg/day supplemented with amino acids (first group; 10 patients) and selective protein restricted diet with 0.6 g/kg/day of high biologically valuable proteins (second group; 9 patients). Both diets showed a good patient compliance. The serum urea level decreased significantly only in the first group of patients with a simultaneous disappearance of uremic gastrointestinal side effects. Progression of renal failure, shown by plotting the reciprocal of the serum creatinine concentration against the time, was significantly slower in the first group of patients and therefore their survival without dialysis was longer than that in the second group. The nutritional state was well maintained in both groups. Comparison of two low protein diets showed that the unselected protein diet supplemented with amino acids is more effective in delaying the progression of renal failure. The clinical state of patients is improved and their protein nutrition maintained.