ROBERT K. MADDOCK JR., M.D.; H. A. BLOOMER, M.D., F.A.C.P.; SACHIKO W. DE ST. JEOR, M.S.
Uremic symptoms can be controlled and nitrogen equilibrium established by means of low protein diets, but certain principles of nutrition must be observed. Only "high biologic value proteins" (meat, eggs, and milk) supply balanced quantities of essential amino acids vital for new protein synthesis. "Low biologic value proteins" (starches, cereals, fruits, and legumes) while good calorie sources, impose an unusable nitrogen load. The decrease of dietary protein to a minimum demands a marked increase in calories, vitamin supplementation, and almost exclusive use of "high biologic value protein" at each meal in order to provide enough essential amino acids in proper proportions. A varied, nonformula, 40-g diet that will maintain nitrogen equilibrium is feasible in a hospital. However, outpatients who purchase or prepare their own meals cannot easily reduce their daily protein intake below 60 g unless they are willing to subsist on ice cream.
ROBERT K. MADDOCK, H. A. BLOOMER, SACHIKO W. DE ST. JEOR. Low Protein Diets in the Management of Renal Failure. Ann Intern Med. 1968;69:1003–1008. doi: 10.7326/0003-4819-69-5-1003
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Published: Ann Intern Med. 1968;69(5):1003-1008.
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