Low protein diets are mainstay for management of chronic kidney disease

Low protein diets, made either of natural foods or of L-essential amino acids and/or their nitrogen-free ketoanalogues, are feasible, safe, and efficient means to reduce disease progression in patients with chronic kidney disease and do not prejudice patient outcomes once they get into Renal Replacement Therapy. They ameliorate symptomatology, grant a positive nitrogen balance, reduce proteinuria, improve osteodystrophy and lipid profile, reduce serum concentrations of uric acid, phosphate, and maintain plasma bicarbonate within normal limits thus preventing metabolic acidosis. They also reduce the number of hypotensive drugs and the quantity of erythropoietin to be administered to achieve target hemoglobin concentrations, and do not deteriorate quality of life. On the contrary, they retard progression of chronic kidney disease. There is a need to motivate patients to increase adherence to prescription and dietitians to escape the risks of malnutrition.