Nutrition therapy in renal disease.

Dietary therapy in chronic renal insufficiency has as its principle aim preservation of residual renal function and to a lesser extent addresses metabolic abnormalities--notably relating to calcium, phosphorus, and vitamin D. Assuring an adequate calorie intake and determining a safe low level of protein and phosphorus are therapeutic goals. Dietary therapy in chronic renal failure emphasizes the goal of avoiding the metabolic problems--particularly those relating to excess dietary protein and phosphorus. Lowering protein and phosphorus to levels at or below the recommended level for normal adults has beneficial effects. However the issue of what level of intake is adequate or safe has not been fully addressed. While comparable studies in infants and children are more difficult, the effects of lower intakes upon growth are a rigorous test of adequacy or safety for this therapy.