Prevention of Progression of Kidney Disease

摘要: SUMMARY OF THE EVIDENCE In summary, there is no convincing or conclusive evidencethat long-term protein restriction delays the progression ofCKD. The longest lasting, largest and best-designed RCT(MDRD study) argues against an important benefit. Fourmeta-analyses have demonstrated either a modest sub-stantial benefit of protein-restricted diets, but three theseused inappropriate outcome measure (renal survival),which does not allow distinction between delay dialysisdue to suppression uraemic symptoms vs. slowing renalfailure progression. only meta-analysis which used esti-mated GFR as found very weakbenefit dietary restriction. It also evidenceof possible publication bias favouring beneficial effect oflow diets. trials showed some heterogeneity andcannot substitute for properly conducted RCTs. Moreover,the possibility low-protein diets onrenal failure must be weighed risk ofa concomitant decline in nutritional parameters. Only threeof 11 RCTs non-diabetics addressed ofrestricted on nutrition