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Home > Archive > Kidney Failure > October 2006 > Re: Dr Walser ONE MORE with LOTS of answers. (Google MacKenzie Walzer, MD)
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Re: Dr Walser ONE MORE with LOTS of answers. (Google MacKenzie Walzer, MD)
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John Hopkins university School of Medicine, Baltimore, MD 21205, USA.
A very low protein diet (0.3 g/kg ideal body weight) supplemented with
essential amino acids (or ketoanalogues) is seldom employed at present
in chronic renal failure for fear of inducing protein deficiency,
especially in patients who also have the nephrotic syndrome.
Nevertheless, we have used this dietary regimen in predialysis
patients for a number of years. We have shown that when these patients
reach the end stage, they rarely exhibit hypoalbuminemia, in contrast
to the reported 25-50% hypoalbuminemia at the onset of dialysis
nationwide. Furthermore, their survival for the first 2 years on
dialysis is much improved, in comparison with the national experience,
adjusted for age, sex, and cause of renal disease. When nephrotic
patients are given this regimen, they exhibit some improvement in
parameters of the nephrotic state, but nevertheless progress to
dialysis, provided their initial glomerular filtration rate (GFR) is <
30 ml/min. However, if their initial GFR is > 30 ml/min, they may show
gradual but complete remission of the nephrotic syndrome, even when
the underlying disease is diabetic nephropathy or focal segmental
glomerulosclerosis. We conclude that this dietary regimen is not only
safe in patients with renal failure, with or without the nephrotic
syndrome, but may be of substantial benefit. The mechanism remains to
be explaine
On Sat, 07 Oct 2006 11:17:36 -0700, jason@nospam.com (Jason Johnson)
wrote:
>In article <eg8nmq$n4o$1@emma.aioe.org>, Dennis R <ds_rekuta@yahoo.ca> wrote:
>
> Dave wrote:
>
>
> Jason pushes this book as the be-all and end-all for treating E.S.R.D.
> From the author's and publisher's site, the latest edition was 2004,
> though when the research it was based on was conducted is not listed.
> Jason, could you reference that from the bibliography for us? From the
> web sites and reviews, what I gathered was that it was a program to
> avoid dialysis as long as possible, not really for someone going on
> dialysis.
>
> I also can't remember from this summer's threads whether Jason has
> actually had E.S.R.D., knew some who did, or just was worried that he
> might have it.
>
> Dennis (Kidney Transplant 1995)
>
>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>
>Dennis,
>I have read the book and I agree with your understanding of the book. The
>major goal of his treatment program is to help people avoid dialysis. The
>entire title of the book is:
>
>COPING WITH KIDNEY DISEASE--A 12 STEP PROGRAM TO HELP YOU AVOID DIALYSIS
>by Mackinzie Walser, M.D.
>
>I do NOT have ESRD. My GP doctor believes that I MAY have Renal Tubular Acidosis
>(type 1).
>Dr. Walser's book helped me understand the reasons why I was having acidosis.
>
>Related to your question about references, Dr. Walser has the titles of
>about 100 research studies in the "Notes" section of his book. I copied
>some dates from the studies related to the very low protein diet:
>1999
>1992
>1991
>2000
>1984
>1999
>2003 ("High Protein Foods Aggravate Several Aspects of Kidney Failure")
>1964
>1975
>1976
>2000
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