Protein Restriction and Graft Survival

[stauffenberg]

A number of newly published medical journal articles backed by recent research suggest that restriction of dietary protein intake considerably extends the life of the transplanted kidney.  Unfortunately, these authors are recommending a restriction of dietary protein to 0.7 gms of protein per day per kilogram of body weight, which for a person of say 130 lbs. would mean a total protein intake of no more than one and a half eggs a day, or only one-sixth of a normal sized 8 oz. steak per day.  Has anyone tried this diet and had success with it in preventing the gradual increase in creatinine levels normally found in renal transplant patients?  The authors also recommend a completely salt-free diet along with the protein restriction.  And you thought the dialysis diet was bad!

[livecam]

Can you link to an article that describes this?  If this is true I think I am going to modify my diet.  I don't want any more dialysis!

[Razman]

I am not on dialysis YET but I have been on a similar diet for the past  3 years.  No salt, no eggs ( I have egg whites only) and I keep protein to less than 4 oz a day and some days I have almost none.  It seems to be working but I have no idea what would have been different if I had not gone on the diet.

[stauffenberg]

The best study proving the benefits of dietary protein restriction on renal graft survival is A. Bernardi, et al, "Dietary Protein Intake and Nutritional Status in Patients with Renal Transplant," Clinical Nephrology, vol. 52, no. 4 (April, 2000) Supplement 3-5.  The recommended restriction is very severe, however, amounting only to an ounce and a half of protein per day for an adult weighing 130 libs.

There is a downside to this restriction, however, in that it can make patients tired, weak, and can contribute to anemia.  Muscle mass will also be reduced.  So you should discuss with your doctor the pros and cons of the restriction for your particular case.

[KT0930]

A. Bernardi, et al, "Dietary Protein Intake and Nutritional Status in Patients with Renal Transplant," Clinical Nephrology, vol. 52, no. 4 (April, 2000) Supplement 3-5.

What concerns me, aside from the obvious of restricting protein by that much, is how old this article is. When I was working on my degree and writing papers, the profs didn't want any sources that were over 18 months old, and even those over 12 months were questionable. Just something to consider since things in medicine change so rapidly.

[BigSky]

When I had my transplant I was told I needed to consume extra protein.  Roughly 7  servings a day if I remember correctly.  There was never a rise in my creatinine from post transplant through all the years until the transplant contracted nephritis again, at which time it brought the nephritis caused the kidney to fail within months.

[stauffenberg]

In fact it is a total myth that medicine advances rapidly and that information quickly becomes out of date.  The article I cited is one of about 20 discussing the benefits of protein restriction, some published as recently as 2007, and I cited the one I did just because it gives the clearest arguments and the best data.

I work as a medical historian, and I have found that in almost every branch of medicine, if I have someone hand me medical journals randomly off the shelf and I don't look at the date they wre published, I cannot tell whether the articles I am reading were printed in 1987 or 2007.  The open secret among historians of medicine is that medicine has been stagnating for a long time now.  The last major disease cured was polio more than half a century ago, almost all patents for new drugs issued in the last 15 years are just minor modiifications of existing patents to allow different companies to profit from them, and the treatment of most chronic illness is positively antique -- from diabetes (today's treatment is little changed from that in 1921) to dialysis (the last major change was with the general introduction of EPO and cyclosporine ca. 1980).  Just pick any medical journal  off the shelf of the medical library and look at the footnotes of any article: you will find studies going back 20 years routinely cited with no concern about their age.

[paddbear0000]

or only one-sixth of a normal sized 8 oz. steak per day.

Shame, shame. The serving size of meat is supposed to be 4 oz!   

[stauffenberg]

I'm surprised to read that statement from a big black dog staring me in the face!  Even my minature dachshunds are willing to drag my whole steak off the table when I'm not looking.

[Zach]

The last major disease cured was polio more than half a century ago

As I'm sure you know, or should know, Polio was not cured.  And has still not been cured.  It's only been prevented widely by the use of vaccine (first developed by Jonas Salk).

So much for being a medical historian.

 

[stauffenberg]

Take it easy Zach.  You wouldn't want people to accuse you of being captious, now would you?  Of course by 'cured' I meant 'removed as a medical problem for society,' not in the technical sense that the disease itself was directly addressed and overcome in cases where it was already established.  But since I was talking about hte ability of medicine generally to 'cure' diseases, whether by preventing them, removing them, epidemiologically annulling their significance, or otherwise dispensing with them, 'cure' seemed the best general term to use.  No one ever cured the plague either, but I'm sure you don't worry about it!

[Zach]

Take it easy Zach.  You wouldn't want people to accuse you of being captious, now would you?  Of course by 'cured' I meant 'removed as a medical problem for society,' not in the technical sense that the disease itself was directly addressed and overcome in cases where it was already established.  But since I was talking about hte ability of medicine generally to 'cure' diseases, whether by preventing them, removing them, epidemiologically annulling their significance, or otherwise dispensing with them, 'cure' seemed the best general term to use.  No one ever cured the plague either, but I'm sure you don't worry about it!

No stauffenberg, cured means cured.  Unless we're talking about blutwurst, leberkäse or jagdwurst.

Polio eradication yes, but cured, no.

You may manipulate words any way you wish, but if a person were infected with polio and become paralyzed, they could not be cured.
 

PS: It would only take one case of polio from another country to bring the disease back if we were not protected by vaccine.
Nigeria, India, Afghanistan and Pakistan are some countries where polio still exists, albeit in very small numbers.

Just the facts:
The Global Eradication of Polio
http://www.polioeradication.org/content/general/current_monthly_sitrep.asp

[st789]

I am doing my best to limit my intake of protein, but it is very difficult to follow.  I am 5'5'' and weight only 120 lbs.

What about the effects of steroid on our muscles and bones?  Damn if you do and damn if you don't.