A practical approach to low protein diets in Sweden- 45 years of clinical use.

This review provides an overview of the development, implementation and practise of low protein diets (LPD) in Sweden. While the current practice is discussed in general terms emphasizing the interplay between nephrologists and dieticians, the "self-selected" LPD model is explained as a practical approach to facilitated patient's adherence to the nutritional therapy. This model is currently implemented in most clinics of the country and gives considerable flexibility regarding variation in meal planning, food selection, amounts consumed, cooking methods as well as adaptations to day-to-day changes. Current LPD use in Sweden is presented through analysis of the Swedish Renal Registry. Finally two patient cases are illustrated, with examples on their diets, attempts to reduce the protein content to the desired thresholds and their clinical course.