Outcome of nutritional status and body composition of uremic patients on a very low protein diet

Abstract Concern has been raised about the nutritional adequacy of a very low protein diet (VLPD). Monthly clinical evaluation by a physician and dietitian and quarterly dietary records, anthropometric measurements, blood testing, and dual energy X-ray absorptiometry (DEXA) were used to assess the course of nutritional status for 1 year in 10 clinically stable patients (six men, four women; age, 57.1 ± 9.3 years) with advanced chronic renal failure (mean glomerular filtration rate, 13.2 ± 4.8 mL/min/1.73 m 2 ). These patients received a VLPD providing 0.3 g/kg/d of protein and were supplemented with amino acids and ketoanalogues. Conventional nutritional markers remained unchanged after 1 year of the VLPD. However, during the same period, whole-body DEXA showed a significant decrease in lean tissue from 46.2 ± 10.2 to 45.0 ± 9.8 kg ( P P P P