The Low Protein Diet is deficient in protein and can somehow result in muscle wasting. This is an effect of muscle protein being broken down to supply amino acids to the body for daily use. This diet may sometimes also be low in iron, calcium, thiamine (Vitamin B-1), riboflavin (Vitamin B-2), and niacin (Vitamin B-3) and so a nutritional supplement may be necessary to prevent deficiency. Protein is usually found in animal foods however it can also be found in various plant foods. The One may need this diet if one has liver or kidney problems or gout. One’s body may usually not able to handle extra protein if one has these health problems. Protein Restricted Diet is very useful for the management of liver and chronic kidney diseases. For optimal results protein-rich foods should be taken in throughout the day rather than at one meal.

Protein includes 16% nitrogen which the body eradicates in the urine as urea. In cases where liver or kidney function is damaged, ammonia or toxic nitrogen metabolites may possibly build up in the blood. These toxins add up to kidney disease and most likely may produce behavioral changes such as psychosis, delusions and hallucinations. The Low Protein Diet is designed to lessen these nitrogen metabolites and ammonia in individuals with liver disease, toxic bowel or kidney failure. In order to achieve these objectives, dietary protein should be limited to 0.6 gram/kg (2.2 lbs) of body weight or around 40 to 50 grams per day.

As the kidneys gradually fail, the remaining nephrons have to take over the load. By decreasing this load, one can preserve the life of the kidney. Proteins in particular need higher levels of filtration. Protein restriction must only be used in patients who are adequately nourished. Essential amino acid supplements can be helpful to allow further restriction. We do not limit dietary protein below 0.6 gram per kilogram of body weight, and regulate for albumin losses in patients who are nephrotic. Measurement of urine urea nitrogen may help guide patients as this measurement usually equates with protein intake.

The following demonstrates some reasons for a Low Protein Diet:

• Dietary protein restriction aids in preventing glomerular hypertension in experimental representations of chronic renal disease.
• The Modification of Diet in Renal Disease data together with meta-analysis of recent trials has revealed that protein restriction may slow or retard the progression of renal disease.
• Low protein diets were revealed in a meta-analysis to slow the development of renal disease in both non-diabetics and diabetics.
• Patients who are on a low protein diet is required to be monitored by a qualified dietitian, and should be checked on a regular basis. The urine urea nitrogen is normally a good indicator of protein ingestion, and can be used as a feedback tool.
• Patient and staff motivation are essential elements to making this dietary lifestyle work. (0.31 X body weight (kgs) + (Urine nitrogen X 6.25) = protein intake when in metabolic balance).
• If serum albumin stocks up start to fall, in that case the diet needs to be adjusted.

Nutrition

• As the glomerular filtration rate reduces the state of nutrition may possibly worsen. Nutrition drops when the creatinine clearance drops below 25cc/minute.
• Serum albumins lesser than 4.0 grams/dl indicate malnutrition in renal patients.
• Patients with creatinine clearance lower than 10 cc/min will most likely have decreased appetites, and hence reduce their protein intakes to as low as 0.6 gm/kg/bw.
• Mortality risk is a role of the serum creatinine at entry into the dialysis program. It is also linked with a lower than normal serum albumin level.
• A low serum albumin is as well a risk factor for cardiac disease in dialysis patients.