61. Renal Disease Patients with early renal disease, when treated with proper diet, exercise and medicationby their physician, can definitely prolong the progression of their http://louisvilledoctor.com/healthtopics/Renal.htm

62. CKD: Co-morbidities: Malnutrition Modification of diet in renal disease Study Group. N Engl J Med 330877884, 1994. Modification of diet in renal disease Study group. http://info.med.yale.edu/intmed/nephrol/pages/Malnut.html

Identifying and treating co-morbid conditions Malnutrition Robert Reilly, M.D. Malnutrition at the onset of dialysis; and patients who are either uninsured or unemployed. An analysis of the Dialysis Morbidity and Mortality Study Wave 2 showed that only about one-half of patients with chronic kidney disease have seen a dietician before the onset of dialysis. When malnutrition is present increased protein intake of 1.0-1.2 g/kg is advisable. Measurement of urinary urea nitrogen can be performed to monitor protein catabolic rate and protein intake. Some nephrologists recommend the restriction of dietary protein to retard the progression of chronic kidney disease. The Modification of Diet in Renal Diseases (MDRD) Study failed to show a statistically significant beneficial effect of protein restriction over a 2-3 year period. This is the largest randomized controlled study of dietary protein restriction ever conducted and included 840 patients with a variety of kidney diseases excluding diabetic nephropathy. Those patients with moderate renal disease (GFR 25- 55 ml/min/1.73 m ) who were assigned to the low protein group had a faster mean decline in GFR during the first 4 months and a 28% slower rate of decline thereafter. However, after 3 years the decline in GFR was only 10% less in the low protein diet group compared with the usual protein diet group (not statistically significant). A meta analysis of dietary protein restriction in diabetics and nondiabetics did show a beneficial effect of protein restriction. Although there is no consensus among nephrologists on this issue, at the present time the beneficial effects of protein restriction appear too small to warrant its use especially in those who are malnourished.

63. LOOKING For: End Stage Renal Disease Dialysis Patients Return to the Special diet Recipes Forum Post a FollowUp LOOKINGfor end stage renal disease dialysis patients. Posted by gran2oo http://ths.gardenweb.com/forums/load/specex/msg0510501614378.html

rems = ""; document.write(rems); Return to the Special Diet Recipes Forum Post a Follow-Up LOOKING for: end stage renal disease dialysis patients Posted by My Page ) on Mon, May 27, 02 at 10:50 I am in need of recipes w/o tomatoes and tomato sauce. No potatoes, no milk lots of no nos. Reipes must be low in phosphous (I should have looked up how to spell) LOL. And also low in potassium. Any help would be appreciated. Follow-Up Postings: RE: LOOKING for: end stage renal disease dialysis patients Posted by: My Page ) on Wed, Jun 5, 02 at 2:04 I think you should ask the nephrologist for a referral to a dietician or call the staff at the dialysis unit for names of a dietician. I found a website that may help. Here is a link that might be useful: Resource for dietary info for ESRD RE: LOOKING for: end stage renal disease dialysis patients Posted by: friedalp My Page ) on Fri, Nov 8, 02 at 16:57 This is for gran2oo. You can occasionaly use potatoes provided you chop and soak them for 6-8 hours and disgard water afterward. Then you can prepare them anyway you like. My mother recently started dialysis due to kidney failure as a result of her diabetes. I have also moved her in with me to take care of her. So I am faced with the challenge of preparing special meals. I just focus on all the things she CAN eat and that's it! I replace the tomatoes with the small green tomatillos and I also use red or green hot sauces choosing the labels with the least amount of salt. Good luck!

64. Chronic Renal Failure Progression of renal disease diet. diet and progression of renal disease Proteinrestriction. diet and progression of renal disease Phosphorus restriction. http://www.vet.ohio-state.edu/docs/VM602/ppt/crf/

Chronic renal failure Click here to start Table of Contents Chronic renal failure Chronic renal failure (CRF) Causes of CRF in dogs Causes of CRF in cats Causes of CRF in large animals Differentiation of CRF from ARF Uremia as an intoxication Concept of hyperfiltration Concept of hyperfiltration Concept of hyperfiltration Proteinuria and glomerular sclerosis in remnant nephrons are adverse effects of hyperfiltration that may lead to progression of renal disease Concept of hyperfiltration Factors contributing to the progressive nature of renal disease Progession of renal disease: Species differencres and extent of reduction in renal mass Progression of renal disease: Functional and morphologic changes in remnant renal tissue Progression of renal disease: Time followed Progression of renal disease: Diet Diet and progression of renal disease: Protein restriction Diet and progression of renal disease: Phosphorus restriction Diet and progression of renal disease: Caloric restriction Diet and progression of renal disease: Lipids Progression of renal disease: Systemic complications of renal insufficiency Progression of renal disease: Therapeutic interventions Concept of external balance Intact nephron hypothesis (Bricker) Maintenance of glomerulotubular balance in progressive renal disease “Trade off” hypothesis (Bricker) “Trade off” hypothesis Different responses for different solutes Different responses for different solutes BUN, creatinine (no regulation)

65. CTF Selected References: Dipstick Proteinuria Screening And Renal Disease The Modification of diet in renal disease Study Group The modification of diet inrenal disease study design, methods and results from the feasibility study. http://www.ctfphc.org/References/Ch38bib.htm

Canadian Task Force on Preventive Health Care Selected References Dipstick Proteinuria Screening of Asymptomatic Adults to Prevent Progressive Renal Disease Prepared by Ryuta Nagai, MD, FRCPC, Research Associate, Department of Preventive Medicine and Biostatistics, Elaine E.L. Wang, MD, FRCPC, Associate Professor of Pediatrics and of Preventive Medicine and Biostatistics, and William Feldman, MD, FRCPC, Professor of Pediatrics and of Preventive Medicine and Biostatistics, University of Toronto, Ontario These recommendations were finalized by the Task Force in June 1993 1. von Bonsdorff M, Koskenvuo K, Salmi HA: Prevalence and causes of proteinuria in 20-year-old Finnish men. Scand J Urol Nephrol 2. Alwall N, Lohi A: A population study on renal and urinary tract diseases. Acta Med Scand 3. Chen BT, Ooi B-S, Tan K-K, et al: Comparative studies of asymptomatic proteinuria and hematuria. Arch Intern Med 4. Levitt JI: The prognostic significance of proteinuria in young college students. Ann Intern Med 5. Haug K, Bakke A, Daae LN

66. Virtual Hospital: Department Of Internal Medicine: Renal Disease Education Peritoneal dialysis patients may not have as many restrictions placed on the diet. Payment.In 1970 End Stage renal disease was added to the Medicare Act. http://www.vh.org/adult/patient/internalmedicine/faq/renaldisease.html

For Patients The University of Iowa Hospitals and Clinics: Department of Internal Medicine Renal Disease Education Frank Gedney, Technical Director Diane Huber, Ph.D. Peer Review Status: Internally Peer Reviewed This education page is designed for patients, families, and other individuals interested in learning more information about kidney failure and treatment options. What is the function of the kidney? The kidney has three basic functions: Filter: The kidney acts as a filter to remove waste products and fluids. Blood pressure control: The kidney acts with a substance, renin, to control blood pressure from becoming high. If the kidneys are not removing enough fluid, urine, blood pressure can rise. The heart works harder pumping blood to the body when there is extra fluid to be pump blood through. Hormone production: The kidney produces a hormone, erythropoetin. This hormone is responsible for red blood cell production in your bone marrow. The kidney also produces the active form of Vitamin D so a person is able to absorb calcium. What are the kidneys?

67. Culinary Kidney Cooks -> Dialysis Cookbooks, Kidney Disease Nutrition, Renal Die Of the 3 renal diet cookbooks which I have bought information with it as far as dietexchanges, sodium family to cope with proper nutrition and kidney disease. http://www.culinarykidneycooks.com/comments.htm

Here are a few comments we have received about "Cooking for David: A Culinary Dialysis Cookbook": "Hi! What a great job on your cookbook. Bravo!" -Joyce O'Dea, R.D. Rocky Hill, Connecticut "I just want to thank you for your cookbook. My father lives in Georgia and received a lot of information about what he could NOT eat, but nothing helping him prepare meals about what he COULD eat. I sent him your book and he is so impressed and so much happier and relaxed about his upcoming dialysis. Thank you Thank you Thank you!" - Betsy Rutherford "Hello Culinary Kidney Cooks, My colleague and I have thoroughly enjoyed and are promoting your cookbook in our dialysis unit. We just printed your recipe of the week for our patients." -Marla McKerracher R.D. Richmond Hill, Ontario "I just want to compliment you on your "Cooking for David" cookbook which I just received yesterday. Of the 3 renal diet cookbooks which I have bought

68. Cardiovascular Disease In Chronic Renal Disease for Primary and Secondary Prevention of Cardiovascular disease in Chronic renal disease. Hyperglycemia(in Diabetics), ++, , diet a Insulin Oral Agents a Pancreas http://www.kidney.org/professionals/pysfile/cardiointro.cfm

Search Browse Please Select a Topic A to Z Health Guide Bed-Wetting NKF Brochures Online Dialysis Donor Families Health Information High Blood Pressure K/DOQI Kidney Disease Kidney Stones Message Boards and Chats Organ Donation Other Health Topics Transplant Athletics Transplant Recipients Transplantation Urinary Tract Disease Health Care Professionals K/DOQI Recipients Government Relations ... Show Your Support CONTROLLING THE EPIDEMIC OF CARDIOVASCULAR DISEASE IN CHRONIC RENAL DISEASE: What Do We Know? What Do We Need to Learn? Where Do We Go From Here? EXECUTIVE SUMMARY Report from the National Kidney Foundation Task Force on Cardiovascular Disease October 1998 Andrew S Levey, MD (Chair), Judith A Beto, PhD, RD, Boris E Coronado, MD, Garabed Eknoyan, MD, Robert N Foley, MSc, MB, Bertram L Kasiske, MD, Michael J Klag, MPH, MD, Lionel U Mailloux, MD, Connie L Manske, MD, Klemens B Meyer, MD, Patrick S Parfrey, MD, Marc A Pfeffer, MD, PhD, Nanette K Wenger, MD, Peter W F Wilson, MD, Jackson T Wright, Jr, MD, PhD Rationale Clinical Recommendations Research Recommendations Tables and Figures CVD Mortality by Gender, Race and Target Population

69. PCRM--Nutrition Curriculum--Section Six A wellplanned diet can replace lost protein and ensure efficient control hypertension,edema, and hyperlipidemia, and slow the progression of renal disease. http://www.pcrm.org/issues/Nutrition_Curriculum/nutr_curr_6.html

Nutrition Education Curriculum Section Six: Nutrition and Renal Disease Urine formation consists of three basic processes: glomerular filtration, tubular secretion, and tubular reabsorption. Several disease conditions can interfere with these functions. Inflammatory and degenerative diseases can involve the small blood vessels and membranes in the nephrons. Urinary tract infections and kidney stones can interfere with normal drainage, causing further infection and tissue damage. Circulatory disorders, such as hypertension, can damage the small renal arteries. Other diseases, such as diabetes, gout, and urinary tract abnormalities can lead to impaired function, infection, or obstruction. Toxic agents such as insecticides, solvents, and certain drugs may also harm renal tissue. Nephrotic Syndrome In nephrotic syndrome, an injury to the glomerular basement membrane causes an increased glomerular permeability, resulting in the loss of albumin and other plasma proteins in the urine. Urinary protein losses greater than 3-3.5 grams per day usually indicate nephrotic syndrome. Although albumin synthesis in the liver is increased in nephrotic syndrome, it is not enough to compensate for losses in the urine. The loss of albumin leads to edema.

70. PCRM--Preventive Medicine And Nutrition Men's Health Prostate Cancer and diet; Prostate Problems A New Approach. renaldisease Nutrition and renal disease Excerpted from PCRM's Nutrition Education http://www.pcrm.org/health/Preventive_Medicine/

PCRM is pleased to provide fact sheets on several preventive medicine and nutrition topics: Arthritis Arthritis and Foods Calcium Calcium and Strong Bones: Protecting Your Bones Cancer Breast Cancer Colon Cancer Hormone Replacement Therapy and Cancer Prostate Cancer ... La Comoida Vegetariana Poderosa Para la Salud For more information, please visit www.CancerProject.org Cholesterol Cholesterol and Heart Disease Controlling Cholesterol Diabetes Diabetes and Diet Neurological Diseases Alzheimer's Disease Multiple Sclerosis: Treating MS with Diet Parkinson's Disease Healthy Living How to Eat Right to Reduce Stress Permanent Weight Control Quitting Smoking Heart Disease Heart Disease, Cancer, Stroke: Research on the Major Killers of Americans High Blood Pressure High Blood Pressure (Hypertension) Foodborne Diseases Foodborne Illness Mad Cow Disease: The Risk to the United States Hypoglycemia Hypoglycemia and Diet Men's Health Prostate Cancer and Diet Prostate Problems: A New Approach Migraines Migraines: A Natural Approach Osteoporosis Preventing and Reversing Osteoporosis Excerpted from PCRM's Nutrition Education Curriculum Calcium and Strong Bones: Protecting Your Bones Renal Disease Nutrition and Renal Disease Excerpted from PCRM's Nutrition Education Curriculum Women's Health Endometriosis Hormone Replacement: The Risk of HRT Update on HRT Menstrual Pain: Using Foods Against Menstrual Pain ... Pregnancy and Smoking

71. Kidney renal disease affects an unusually large number of dogs. renal damage is progressive,so if untreated, normal affected dogs a controlled diet usually preserves http://www.naturalcanine.com/html/kidney.html

QuickFind Selector Select Dog's Condition Aggression Allergies Anal Glands Appetite (loss of) Arthritis/Joints Behavioral Disorders Blood in the urine Bones Bronchitis Cancer Car/Travel Sickness Constipation Corophagia (eating poop) Cough Cushings Dandruff Detoxification Diabetes Digestion Discoid Lupus Ears Encephalitis Eyes Fleas/Ticks Giardia Heart Heartworm Hypothyroidism Incontinence Kennel Cough Kidneys Lipoma Liver Mange Mastitis Nasal Discharge Pancreatitis Paralysis Pica (eating rocks) Poisoning Prostate Separation Anxiety Skin Spondylitis Teeth/gums Throat Thunder Trachea Urinary crystals Vaccine Reactions Vaginitis Vomiting Worms What is Renal disease? Renal Disease affects an unusually large number of dogs. Renal damage is irreversible; dogs lose structure and function in affected nephrons (kidney cells). Renal damage is progressive, so if untreated, normal nephrons are destroyed. Dietary management is geared toward preserving normal nephrons. Feeding affected dogs a controlled diet usually preserves remaining nephrons function. Diets must have proper amounts of calcium, magnesium, sodium and potassium. Concentrations of certain vitamins must not exceed requirements. Dietary protein is sometimes reduced to a minimum. Feeding 3 small meals per day is recommended. Please note each diet is designed to meet varying requirement of sodium, potassium, calcium and phosphorus. At the end of each recipe, directions are given for restoring normal phosphorus levels.

72. Feline Future Cat Food - Reduced In Protein And Phosphorus with only a small fraction of normal renal tissue A diet restricted in protein andminerals also helps may be beneficial in slowing progression of the disease. . http://www.felinefuture.com/nutrition/rprecipe.php

Main Search Contact Legend ... go back Recipe for preparing the "Feline Future Cat Food" - reduced in protein and phosphorus Download this recipe in PDF format Fresh Ingredients: 900g (2 lbs.) raw Muscle Meat 100g (3.5 oz. or 1/2 cup) raw Liver 700 g (25 oz.) canned Pumpkin 1 cup Water 4 raw Egg Yolks Supplements: 2000 mg Calcium Citrate 250 mg Magnesium Citrate 2 Tbsp. Gelatin 1 tsp. powdered Dulse 1 tsp. powdered Kelp 2000 mg Salmon oil 2 Tbsp. Cod liver oil = 10,000 IU 2000 mg Taurine 600 IU Vitamin E 2 capsule of a 50mg Complex B Vitamin supplement Yields ~ 18 x 1/2 cup portions 1.) choose meats with a high fat content; e.g. poultry with skin, regular ground beef/hamburger, or lamb. Use these meats ground 2.) do not replace dulse with kelp, as this would result in a potentially harmful iodine concentration in the diet. Rather omit dulse completely if it isunavailable to you. This recipe is intended for private homeuse only in the care of your own cat(s) and shall not be used for any commercial purpose. We always advise that professional veterinary advice be sought for a proper diagnosis and treatment if your cat is/your cats are unwell. The following recommendations and recipe have been carefully researched and formulated. Feline Future can, however, not be held responsible for the use of any recommendations and recipes mentioned in any manner other than specifically instructed, nor can Feline Future be held responsible for any possible adverse reaction a cat/cats may experience to the recommendations or recipes. All components of this formulation are essential. Omitting, replacing, increasing or decreasing one ore more ingredients will disturb the nutritional balance and can result in severe illness of your cat.

73. NEJM -- The Effect Of Protein Restriction On The Progression Of Renal Insufficie Full Text; Klahr, S., Levey, AS, Beck, GJ, Caggiula, AW, Hunsicker, L., Kusek,JW, Striker, G., The Modification of diet in renal disease Study Gr, (1994). http://content.nejm.org/cgi/content/abstract/321/26/1773

HOME SEARCH CURRENT ISSUE PAST ISSUES ... HELP Volume 321:1773-1777 December 28, 1989 Number 26 Next The effect of protein restriction on the progression of renal insufficiency BU Ihle, GJ Becker, JA Whitworth, RA Charlwood, and PS Kincaid-Smith Table of Contents Find Similar Articles in the Journal Notify a friend about this article Journal Watch (General) Summary ... Related Articles in Medline Articles in Medline by Author: Ihle, B. U. Kincaid-Smith, P. S. Medline Citation Abstract Source Information Department of Nephrology, Royal Melbourne Hospital, Victoria, Australia. This article has been cited by other articles: Rahman, M., Smith, M. C. (1998). Chronic Renal Insufficiency: A Diagnostic and Therapeutic Approach. Arch Intern Med [Abstract] [Full Text] Malvy, D., Maingourd, C., Pengloan, J., Bagros, P., Nivet, H. (1999). Effects of Severe Protein Restriction with Ketoanalogues in Advanced Renal Failure. J Am Coll Nutr [Abstract] [Full Text] (1990). PROTEIN RESTRICTION RETARDS PROGRESSION OF RENAL FAILURE. Journal Watch (General) [Full Text] Lemann, J., Shiigai, T., Nonoguchi, H., Tomita, K., Fishbane, S., Klahr, S., Levey, A. S., Beck, G. J. (1994). Dietary Protein Restriction and Blood-Pressure Control in Chronic Renal Insufficiency.

74. ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Diet For Kidney D A diet used in the treatment of renal (kidney) disease. It may be lowsodium,low-potassium, and protein and fluid restricted. Learn http://www.enlmedical.com/article/002442.htm

Medical Dictionary Naturapathic Glossary Aphrodisiacs Immune System ... Table of content Diet for kidney disease Food Sources: This diet controls the amount of fluid, protein , sodium, and potassium. The controlled amounts of each of these nutrients are based on the person's blood levels of potassium, sodium, and urea, as well as the fluid balance, creatinine clearance , and blood pressure . If the blood levels indicate the need to adjust the intake of calcium and phosphorus, then the amounts allowed in the diet are changed. Functions: The purpose of a diet that restricts protein , sodium, and potassium is to help the body decrease the waste products produced by metabolism , which are toxic if they are not eliminated from the body. This occurs from certain types of liver and kidney diseases Recommendations: The amount of protein allowed in the diet is determined by checking the amount of protein (and protein metabolic wastes) in the person's blood. Laboratory tests may include chem-20 creatinine albumin , and blood urea nitrogen . Low-protein diets may prevent or slow the progress of some kinds of

75. Baxter - End-Stage Renal Disease Treatment Options (03/06/01) OVERVIEW Endstage renal disease (ESRD) means the kidneys do not work well enough mostpeople undergoing this form of dialysis must limit their diet and fluids http://www.baxter.com/includes/psa/esrdtreatment_01.html

End-Stage Renal Disease Treatment Options OVERVIEW End-stage renal disease (ESRD) means the kidneys do not work well enough to keep a person alive. Today there is no known cure for ESRD but there are successful treatment options. The two treatment options used when kidneys fail are dialysis (hemodialysis and peritoneal) and transplantation. Dialysis is the medical treatment for eliminating waste and extra fluid from the bloodstream that the kidneys can no longer remove. Kidney transplantation is an operation performed by a surgeon to replace the damaged kidney with a healthy one from another person. Due to the limited number of donor kidneys, the vast majority of people with ESRD - more than 300,000 people in the U.S. - rely on dialysis. CHOOSING A TREATMENT Selecting a dialysis treatment modality is a major decision that can impact a patient's quality-of-life while on dialysis. Many factors determine which therapy is best for an individual. A patient and a doctor will:

76. Baxter - End-Stage Renal Disease Treatment Options differences in the treatment options, if not thoroughly educated on treatment optionsfor endstage renal disease a person There are diet and fluid restrictions http://www.baxter.com/includes/psa/esrdtreatment.html

End-Stage Renal Disease Treatment Options End-stage renal disease occurs when the kidneys can no longer work well enough to remove wastes and excess fluids from the body to keep the person healthy. When this happens, excess fluids and waste must be removed from the body by another option. The only two treatment options available for end-stage renal disease are transplantation and dialysis. Due to the limited number of donor kidneys, the vast majority of people with end-stage renal disease- more than 300,000 people - rely on dialysis. Considering the differences in the treatment options, if not thoroughly educated on treatment options for end-stage renal disease a person may select a therapy that is not the best suited for their lifestyle. Consequently, choosing a dialysis treatment is a major decision that can impact a patient's quality-of-life while on dialysis. HEMODIALYSIS During hemodialysis, waste products are removed from the blood through a needle inserted into a blood vessel in the arm or leg. The blood is then pumped through a machine containing a filtering system called a dialyzer that cleanses the blood and returns the cleansed blood back to the body. On average people undergoing hemodialysis must visit a hospital or dialysis center three times a week for a four-hour dialysis session. Home hemodialysis is an option for some patients.

77. EMORY NEPHROLOGIST RECEIVES AMERICAN SOCIETY FOR CLINICAL Mitch led Emory's participation in the largest national study of dietary proteinand chronic kidney disease, the Modification of diet in renal disease Trial. http://www.emory.edu/WHSC/HSNEWS/releases/nov97/mitch.html

EMORY NEPHROLOGIST RECEIVES AMERICAN SOCIETY FOR CLINICAL NUTRITION AWARD November 1997 Media Contacts: Holly Korschun, 404/727-3990 hkorsch@emory.edu http://www.emory.edu/WHSC/ The American Society for Clinical Nutrition recently presented its Robert H. Herman Memorial Award to William E. Mitch, M.D., Garland Herndon Professor of Medicine and director of the Division of Renal Diseases in the Emory University School of Medicine. The award was given "in recognition of Dr. Mitchs fundamental contributions to our understanding of chronic renal failure." Dr. Mitch's research "bridges the basic and applied sciences and has enabled the use of dietary therapy in patients with advanced kidney failure, established a dietary regimen that slows the rate of progression of renal failure, and contributed to our understanding of the metabolic derangements in renal disease and identified a treatable cause of muscle wasting in kidney failure," the award stated. Dr. Mitch is director of Emory's George M. O'Brien Kidney Research Center, one of only five such kidney disease centers established by the National Institutes of Health (NIH). As an internationally known authority on nutritional aspects of kidney disease, his career has been devoted to finding solutions to problems causing protein catabolism and muscle wasting. Although protein is a necessary component of the diet, foods containing protein and phosphorous are the source of acid and other wastes the kidney must eliminate. In patients with chronic renal failure, too much protein in the diet causes toxic buildup, gradually destroying the kidney's blood filtering system and leading rapidly to end-stage disease. Dr. Mitch's research has focused on the connection between high acid levels, uremia and body protein stores on kidney failure.

78. InteliHealth: End-stage Renal Disease to reduce your chances of developing endstage renal disease. of high blood pressurealso can help prevent kidney disease. A low-protein diet (10 percent to 12 http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/23929.html

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79. Cleveland Clinic Foundation Research Institute Data Coordinating Centers for the NIDDKfunded multicenter clinical trials Hemodialysis(HEMO) Study and the Modification of diet in renal disease (MDRD) Study http://www.bio.ri.ccf.org/Resume/Pages/gbeck.html

Gerald J. Beck, Ph.D. Staff, Department of Biostatistics Department of Biostatistics and Epidemiology/Wb4 9500 Euclid Avenue Cleveland, Ohio, 44195 Telephone: Fax: gbeck@bio.ri.ccf.org Brief Description: Dr. Beck is Director of the Data Coordinating Centers for the NIDDK-funded multicenter clinical trials: Hemodialysis (HEMO) Study and the Modification of Diet in Renal Disease (MDRD) Study. He is also Co-Principal Investigator at the Cleveland Clinic Foundation clinical center of two NCI-sponsored clinical trials studying the recurrence of neoplastic large bowel polyps after taking calcium, or aspirin and/or folate. His research interests include the analysis of longitudinal data and clinical trial design and analysis. Key References: Modification of Diet in Renal (MDRD) Disease Study Group (Prepared by Beck GJ, Berg RL, Coggins CH, Gassman JJ, Hunsicker LG, Schluchter MD and Williams GW). (1991) Design and Statistical Issues of the Modification of Diet in Renal Disease Trial. Controlled Clinical Trials,12:566-586. Higgins TL, Estafanous FG, Loop FD, Beck GJ, Blum JM and Paranandi L. (1992) Stratification of Morbidity Outcome by Preoperative Risk Factors in Coronary Artery Bypass Patients: A Clinical Severity Score. Journal of the American Medical Association, 267:2344-2348.

80. TEXAS FOOD AND FIBERS COMMISSION Benefits The results indicate the possible benefit of including cottonseedoil in the diet in renal disease progression. This project http://www.tffc.state.tx.us/TWUNUTRITION/PROGRESS/1998-1999/cotkidney.html

TEXAS FOOD AND FIBERS COMMISSION e-98-99-2 Project Title: Effects of Dietary Cottonseed Oil on the Kidney Investigator: Harold Aukema University/Department: Project Scope: Several studies have shown that diets high in linoleic acid help preserve renal function in animal models. In a study using an animal model of polycystic kidney disease, animals given dietary safflower oil had delayed progression of renal disease compared to animals given a fish oil based diet. Since cottonseed oil has a high level of linoleic acid, it may also promote optimal kidney health. Although the palmitic acid content of the oil has given it somewhat of a tarnished image in the past, recent emphasis on monounsaturated fatty acids may put cottonseed oil in a much better light. Method of Research: In the first year of this proposal, animals with renal disease were given diets that varied only in their source of dietary lipid. Dietary lipids included cottonseed oil, cottonseed/peanut oil blend, beef tallow, palm oil, soybean oil (the lipid source used in the American Institute of Nutrition diet for laboratory rodents), or fish oil. The animal used was a mouse model of polycystic kidney disease. This is a good model of renal disease, and it is expected that effects of diet on the kidney will be exaggerated by using this model. In the second year of the study, using another animal model of renal disease, animals were given diets containing fish oil, soybean oil, or cottonseed oil. Critical Findings: Results of the first study suggest that the cottonseed oil diets may both reduce renal disease progression as well as prevent fatty liver compared to the other diets utilized in this study (fish oil, soybean oil, palm oil, and beef tallow). The other diets either increased kidney weights (indicating increased disease progression) or increased liver weights (indicating possible fatty livers) relative to the diets containing cottonseed oil. The results of the second study indicate that while fish oil appears to retard disease progression compared to both cottonseed and soybean oil, it increases the liver weights, raising the possibility that it may contribute to fatty livers in these animals. These studies illustrate that more than one animal model must be utilized before conclusions can be made regarding the potential health benefits/risks of a particular functional food or nutriceutical.

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