Bibliography 1. Hak E, et al. Clin Infect Dis. 2002;35:370–7. (Level Transmembrane Transporters inhibitor 4) 2. Collins AJ, et al. Am J Kidney Dis. 2008;51:S1–S320. (Level 4) 3. Snyder JJ, et al. J Am Soc Nephrol. 2009;20:1614–22. (Level 4) Is a low AZD8931 protein diet recommended for elderly patients with CKD to control the progression
of CKD? Previous studies suggested that dietary protein restriction can slow progression to ESKD in patients with CKD stage G3b or later. However, it is unclear whether a low protein diet is also recommended for elderly patients with CKD. Since most studies included adults aged ≥65 years with CKD, a possible beneficial effect of a low protein diet in elderly patients with CKD cannot be denied. However, since some elderly patients with CKD are frail, the indication should be carefully determined. The recommended protein intake for elderly patients with CKD is 0.8 g/kg/day, which is the same as that for adults with CKD. Bibliography GW3965 in vivo 1. Fouque D, et al. Nephrol Dial Transplant. 2000;15:1986–92. (Level 1) 2. Fouque D, et al. Cochrane Database Syst Rev. 2006;19(2):CD001892. (Level 1) 3. Rosman JB, et al. Lancet. 1984;2:1291–6.
(Level 2) 4. Rosman JB, et al. Kidney Int. 1989;27(Suppl):S96–S102. (Level 3) 5. O’Hare AM, et al. J Am Soc Nephrol. 2007;18:2758–65. (Level 4) 6. Meloni C, et al. J Ren Nutr. 2002;12:96–101. (Level 3) 7. Meloni C, et al. J Ren Nutr. 2004;14:208–13. (Level 3) 8. Brunori G, et al. Am J Kidney Dis. 2007;49:569–80. (Level 2) 9. Menon V, et al. Am J Kidney Dis. 2009;53:208–17. (Level 3) Is salt restriction recommended to slow the progression of
CKD in elderly patients with CKD? Studies performed in elderly people have revealed that dietary sodium intake probably has an impact on blood pressure as blood pressure is reduced in association with the restriction of sodium intake. Therefore, a low-sodium diet is likely to be effective for lowering the blood pressure of CKD patients and, therefore, mafosfamide also effective for slowing the progression of CKD, even in the elderly. The target salt intake recommended for elderly CKD patients is 3–6 g/day, as is the case for non-elderly CKD patients. However, clinicians should be cautious about an excessive decline of blood pressure and hyponatremia due to a very low dietary sodium intake. Bibliography 1. Luft FC, et al. Am J Hypertens. 1992;5:520–8. (Level 4) 2. Appel LJ, et al. Arch Intern Med. 2001;161:685–93. (Level 2) 3. Alam S, et al. J Hum Hypertens. 1999;13:367–74. (Level 1) Is antihypertensive therapy recommended to prevent the progression of CKD in elderly hypertensive patients with CKD? Results indicating the target blood pressure for CKD patients have been reported, but there has only been a limited number of studies that specifically enrolled elderly patients with CKD.