Indeed, the actual reduction
of only 0.2 g/kg/day of protein intake, regardless
of both the amount of prescribed protein and the degree
of adherence to diet prescription, induces significant improvement
in serum urea, metabolic acidosis and phosphate
levels [10] . As a result, very low-protein diets, regardless
of reduced adherence, achieves better metabolic
effects. A recent study compared two low-protein diets
with 0.60 and 0.35 g/kg/day of protein; the study group
on the 0.35-gram diet reached a major improvement in
lipid profile, proteinuria, calcium-phosphate balance and
hypertension, despite a lower number of patients being
adherent to prescription; this effect was related to the
lower protein intake actually achieved [17] . The same