LAUSR

D ietary protein restriction, with or without supplementation of ketoanalogues of certain amino acids, have long been considered as an attractive intervention to slow progression of chronic kidney disease (CKD). As suggested by several meta-analyses, this effect is real, albeit relatively small in the context of progressive kidney disease. Several smaller studies indicate that the favorable effects of dietary protein restriction extend beyond slowing the progression. These include amelioration of metabolic acidosis and insulin resistance, antioxidant effects, and decreasing dietary phosphorus load. In addition to protein restriction alone, several studies also have examined the effects of keto or amino acid–supplemented lowprotein diets or very low protein diets on certain metabolic and kidney outcome parameters. Data suggest that protein-restricted diets supplemented with keto/amino acids result in a significant decrease in urea production and a beneficial