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Nutrition in Clinical Practice
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Low-Protein Diet Improves Muscle Energy Metabolism in Chronic Renal Failure

Roberto Aquilani, PhD

Nutritional Pathophysiology Service, Nephrology Division

Maurizia Dossena, PhD

Pharmacology Institute, Faculty of Science, University of Pavia, Italy

Paola Foppa, PhD

Pharmacology Institute, Faculty of Science, University of Pavia, Italy

Mariana Catapano, PhD

Pharmacology Institute, Faculty of Science, University of Pavia, Italy

Cristina Opasich, MD

Cardiology Division

Paola Baiardi, DMathSc

Medical Informatics Unit, Fondazione Salvatore Maugeri Clinica del Lavoro E Della Riabilitazione, IRCCS, Pavia, Italy

Alessandro Salvadeo, MD

Ornella Pastoris, PhD

Pharmacology Institute, Faculty of Science, University of Pavia, Italy

To investigate the effects of a low-protein diet (LPD) in chronic renal failure (CRF), muscle biopsies were performed on eight nondialyzed patients before and after 1 year of reduced protein intake (0.5 g/kg/d) with calorie intake equal to 1.4 x resting energy expenditure (1.4 x REE). Serum parathormone, glucagon, insulin levels, blood HCO3-, and pH were measured before and after LPD. The bicycle exercise test also was performed to evaluate exercise tolerance. The control group consisted of 12 healthy sedentary subjects matched for sex, age, and weight. Twelve months of LPD caused an increase in muscle adenosine triphosphate (ATP) concentration (p .001) and a reduction both in citrate (p < .05) and {alpha}-ketoglutarate (p < .05) concentrations. Citrate synthase (p < .05) and alanine aminotransferase (p < .05) activities decreased. No significant changes were noted in hormonal and blood acid-base status. Patients with CRF reported reduced muscle weakness during physical activity after 1 year of LPD: their oxygen consumption (Vo2) peak and Vo2/heart rate (HR) (oxygen pulse) were significantly higher. Our study revealed that 1 year of dietary intake with calories equal to 1.4 x REE can reduce, but not normalize the alterations in muscle energy metabolism due to CRF.

Nutrition in Clinical Practice, Vol. 12, No. 6, 266-273 (1997)
DOI: 10.1177/088453369701200606
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