Muscle protein turnover and low-protein diets in patients with chronic kidney disease.
Nephrol Dial Transplant
; 35(5): 741-751, 2020 05 01.
Article
in En
| MEDLINE
| ID: mdl-32378720
ABSTRACT
Adaptation to a low-protein diet (LPD) involves a reduction in the rate of amino acid (AA) flux and oxidation, leading to more efficient use of dietary AA and reduced ureagenesis. Of note, the concept of 'adaptation' to low-protein intakes has been separated from the concept of 'accommodation', the latter term implying a decrease in protein synthesis, with development of wasting, when dietary protein intake becomes inadequate, i.e. beyond the limits of the adaptive mechanisms. Acidosis, insulin resistance and inflammation are recognized mechanisms that can increase protein degradation and can impair the ability to activate an adaptive response when an LPD is prescribed in a chronic kidney disease (CKD) patient. Current evidence shows that, in the short term, clinically stable patients with CKD Stages 3-5 can efficiently adapt their muscle protein turnover to an LPD containing 0.55-0.6 g protein/kg or a supplemented very-low-protein diet (VLPD) by decreasing muscle protein degradation and increasing the efficiency of muscle protein turnover. Recent long-term randomized clinical trials on supplemented VLPDs in patients with CKD have shown a very good safety profile, suggesting that observations shown by short-term studies on muscle protein turnover can be extrapolated to the long-term period.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Diet, Protein-Restricted
/
Dietary Supplements
/
Renal Insufficiency, Chronic
/
Muscle Proteins
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
Nephrol Dial Transplant
Journal subject:
NEFROLOGIA
/
TRANSPLANTE
Year:
2020
Document type:
Article
Affiliation country:
Italy