Dietary management of chronic renal disease in dogs: A critical appraisal

Autor: D. S. Kronfeld
Rok vydání: 1993
Předmět:
Zdroj: Journal of Small Animal Practice. 34:211-219
ISSN: 1748-5827
0022-4510
DOI: 10.1111/j.1748-5827.1993.tb02664.x
Popis: Diets low in protein have been recommended for dogs with chronic renal failure (CRF) since 1948, and for apparently healthy old dogs since 1960. These recommendations were based on studies of rats and poorly documented clinical experiences with dogs. Since 1979, a series of eight experiments on partially nephrectomised dogs and four clinical trials on naturally occurring chronic renal disease have demonstrated serious disadvantages of diets that contained high (38 to 49 per cent on a metabolisable energy (ME) basis) or very low (3 to 10 per cent) protein. In addition to poor acceptance of low protein (12 and 16 per cent) diets, undesired responses included exacerbation of depressed renal functions, reduced renal reserve, severe hyperfiltration in single nephrons, metabolic acidosis, hypercholesterolaemia, and hypertension. Protein deficiency may not have caused the complications observed, and may have been due to another feature of the diets fed. In seven studies, diets with a moderate (20 to 31 per cent ME) protein level fared better in regard to reduced renal pathology and proteinuria, better renal functions and reserve, and improvement of clinical status, azotaemia, hyperphosphataemia and anaemia. In the first instance, preferred products for CRF should contain moderate (20 to 24 per cent) protein and minimal phosphorus. Taking into consideration these 12 kidney studies a protein content of 30 per cent is recommended for apparently healthy old dogs. Current recommendations are to introduce a diet that is low in protein at a ‘critical point’ in the course of CRF, when its advantages are likely to outweigh its possible disadvantages. When this critical point has been reached has not been determined, but it is likely to be based on an assessment of the individual case.
Databáze: OpenAIRE
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