Optimal dietary protein intake for adults with the nephrotic syndrome has not yet been established; very-low protein diets are believed to be contraindicated. Nevertheless, 22 adults with the nephrotic syndrome were prescribed a very low protein diet (0.3 g/kg) supplemented with 10-20 g/day of essential amino acids (or, in a few cases, ketoacids) for an average of 10 months. In patients with moderate or severe renal failure, modest improvement was seen (on the average) in proteinuria, serum albumin, and serum cholesterol. In patients with less severe renal failure, three failed to improve, but five showed complete or nearly complete remission of their nephrotic syndrome during the ensuing months, beginning with the start of the diet. Four of them eventually resumed normal diets without recurrence of nephrotic syndrome.
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