Importance of early initiation of dietary protein restriction for the prevention of experimental progressive renal disease.

The effect of dietary protein restriction on the progress of renal dysfunction was investigated in rats with adriamycin (ADR)-induced progressive glomerular disease. Dietary protein was reduced from 20% (normal diet) to 5% (low protein) immediately after (ADR-0w), 8 weeks (ADR-8w) or 16 weeks (ADR-16w) after the repeated injection of ADR. In the unrestricted (ADR-UR) group rats were fed 20% of protein throughout the 24-week experiment. Massive urinary protein developed immediately after ADR injection and significantly decreased by reducing dietary protein in all the groups (ADR-0w, ADR-8w, ADR-16w). However, plasma protein and serum albumin were low irrespective of the improvement of urinary protein. BUN and serum creatinine were unchanged in ADR-0w and ADR-8w groups, while they were increased in ADR-16w and ADR-UR groups. Glomerular sclerosis and tubular atrophy were much less severe in ADR-0w and ADR-8w than in ADR-16w and ADR-UR groups. The results indicate that dietary protein restriction checks the further progress of renal dysfunction. The importance of the time when protein intake should be reduced is discussed.