only 3 subjects developed malnutrition (i.e. less than 1%)
[28] ; in contrast, 40–50% of patients on a free diet spontaneously
reduce both protein and energy intake, developing
overt malnutrition at the start of dialysis and thus
demonstrating that a free diet, in contrast to a low-protein
one, may cause malnutrition. Recently, Dukkipati et
al. [29] stated that a low-protein diet provides adequate
amounts of protein for all CKD patients and does not adversely
affect their body composition. Overall, the side
effects of nutritional treatment in CKD are scant and can
be easily prevented with careful clinical monitoring ( table
2 ).