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In a retrospective study of 33 patients the influence of different anamnestic, clinical and laboratory parameters on the progression of renal failure was investigated. The analysis of progression of renal failure was evaluated in terms of a reasonable criterium intuitively suggesting itself which is based on a non-linear fitting of the serum creatinine profile. Follow-up serum creatinine levels showed that renal function became worse in 28 cases, with terminal renal failure developing in 6 cases. In 5 patients significant improvement in kidney function was observed. The variables systolic and diastolic blood pressure, total amount of ingested analgesics, continued abuse and cessation of analgesics, frequency of urinary tract infections and amount of proteinuria had no significant influence on progression of renal failure. However, a strong relationship between the initial serum creatinine level and the progression of renal failure could be established. In conclusion our results indicate that long-term prognosis of analgesic nephropathy mainly depends on early diagnosis. [ABSTRACT FROM AUTHOR]

In recent years dietary protein restriction (DPR) to slow down the progression rate of chronic renal disease has been a major field in nephrological science. In this update a brief historical overview is given, as well as a critical review regarding the now available data from clinical trials. Furthermore, the theoretical backgrounds of DPR are discussed. It is concluded that DPR has profound effects on the kidney. In certain diseases, especially primary glomerular disease, the beneficial effect seems proven. However, many questions remain to be answered, e.g. how to apply reliable statistics in chronic renal failure, how to obtain and monitor patient compliance, and the definition of the exact target group since the diet has a selective effect. Most of these questions will be answered in the coming years when data becomes available from large scale multicenter trials. Awaiting these results, proposals for the treatment with diet are made, based on the facts that are now to our knowledge. [ABSTRACT FROM AUTHOR]