| Jason Johnson 2006-10-07, 9:35 pm |
| In article <nqsfi250ul4sko0sbncftri5nghgskn2lt@4ax.com>, Sando
<sando!@cox.com> wrote:
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 explained
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Sando,
Excellent post. This (see above) is an excellent summary of Doctor
Walser's treatment program. He explains even more details about the
treatment program in his book.
Last summer, I was really worried that I had ESRD when I failed to urinate
for two days in a row. I learned from Dr. Walser's book and from people in
this newsgroup that I did NOT have ESRD. I continue to appreciate the
advice that was given to me by various members of this newsgroup. I also
appreciate the advice that I learned from Dr. Walser's book. For example,
I retain salt and water. Dr. Walser has a chapter in his book entitled,
"Step 4--Treat Salt and Water Problems". He also taught me about Edema and
Diuretics. I learned more from Dr. Walser than I have learned from my
doctor. I have an HMO insurance program. I learned from experience that
HMO stands for Hurry Me Out.
I believe that everyone should take their nephrologist's advice related to
their treatment program.
Jason
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