Body composition modifications in patients under low protein diets.

OBJECTIVE

To review the effect of low protein diets on body composition in patients with chronic kidney disease.

METHODS

A selected literature review of body composition methods applicable to clinical practice, and a chronological appraisal of relevant studies using low and very low protein diets chosen for their major emphasis on nutritional status and body composition were used for the present study.

RESULTS

Body composition methods were categorized by compartments, techniques, ease of use, clinical applicability, advantages, and disadvantages. One publication of body composition in chronic undernutrition was evaluated because of the absence of kidney disease as a confounder. The remaining studies covered chronic kidney disease stages III-V treated with low and very low protein diets.

CONCLUSIONS

Very low protein diets are capable of sustaining mean lean and body cell mass for an extended period in patients with chronic kidney disease stages late III-V. However, intercurrent illness and periods of spontaneous reduction in caloric and protein intake markedly increase the risk for malnutrition. Use of these diets requires regular clinical monitoring by nephrologists and renal dietitians, with particular attention to nutritional surveillance, dietary protein and energy intake, and body composition changes.