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In acute renal failure, dietary protein should be restricted in which of the following?
A) All patients
B) All patients with BUN 100
C) All patients with creatinine 10
D) Only in patients who are well nourished on hospital admission
E) If azotemia is advanced and dialysis is not an option
Posts: 3,675,934
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In acute renal failure, dietary protein should be restricted in which of the following?
A) All patients
B) All patients with BUN >100
C) All patients with creatinine >10
D) Only in patients who are well nourished on hospital admission
E) If azotemia is advanced and dialysis is not an option
Posts: 3,675,934
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The answer is E.
Years before dialysis was routinely available, it was well established that protein restriction
(prescribed or self-imposed) could alleviate some of the symptoms of uremia; unfortunately,
prolonged protein restriction led to the development of malnutrition and its associated
complications. In the setting of chronic renal failure, a number of clinical studies have
suggested that modest protein restriction may slow the rate of progression of renal failure,
particularly in patients with glomerular disease and daily protein excretion rates >1 g/d.
There are insufficient data in the setting of acute renal failure to adequately assess the
importance of protein intake. However, in view of the hypercatabolism that accompanies
many cases of acute renal failure, most practitioners provide adequate protein to patients
(e.g., 1.0 to 1.2 g protein per kg per day) and provide dialysis if uremia ensues. There are
no set laboratory œcutoffs (BUN >100) that indicate the need for dialysis.
