Notes and References

1. Coenzyme Q10 Good for People with Kidney Failure
   
2. In this study, CoQ10 lowered serum creatinine by 29% and blood urea nitrogen by 9%:
   Singh RB, Khanna HK, Niaz MA, "Randomized, Double-Blind Placebo-Controlled Trial of Coenzyme Q10 in Chronic Renal Failure: Discovery of a New Role, J Nutr Environ Med, 2000;10:281-288.36843
   
   
3. Herb of the Season: Stinging Nettle (Urtica dioica) By David Winston, AHG
   
4. These researchers found that  "Diets replete in protein were not associated with increased severity of glomerular or nonglomerular renal lesions, increased proteinuria, or decreased GFR. Diets replete in calories were not associated with increased severity of glomerular lesions, but were associated with mild increase of nonglomerular lesions. Factors other than protein and calorie intake must be considered potential causes of progression of renal failure in cats. Results raise questions about the practice of restricting quantity of protein in the diet of cats with chronic renal failure, with the intention of ameliorating development of further renal damage."
   Finco DR, Brown SA, et al Protein and calorie effects on progression of induced chronic renal failure in cats, American Journal of Veterinary Research, 1998, 59(5): 575–582
   
5. Finco DR, Brown SA, Barsanti JA. "Divergent views on dietary  management of renal failure: The Georgia experience". Proc 16th  Ann ACVIM Forum 1998; 32-33.
   I could not find a link to this paper online, but do have a hard copy of it.  Dr. Finco et al found that feeding cats with CRF diets "replete  in protein" did not accelerate renal failure as measured by serum creatinine/BUN, nor did it have any other negative effects such as uremia and/or azotemia.
   
   In this great literature review, the authors underscore that not only does reduced protein not help, it can hurt.  To wit: "Disadvantages to reduced protein intake include reduced kidney function as measured by GFR and renal plasma flow, possibility of a negative nitrogen balance, and the promotion of acatabolic state in the presence of proteinuria."
   
   
6. Bovee, Kenneth C. DVM, MMedSc,"Mythology of Protein Restriction for Dogs with Reduced Renal Function", Practicing Veterinarian Vol. 21, 11 (K), Nov 1999
   
7. This study showed higher EPA levels and lower AA levels might have a renal-protective effect:
   Plantinga EA, Hovernier R, Beynen AC, Qualitative risk assessment of chronic renal failure development in healthy, female cats as based on the content of eicosapentaenoic acid in adipose tissue and that of arachidonic acid in plasma cholesteryl esters., Vet Res Commun. 2005 May;29(4):281-6.
   
8. Study showing diets hi in EPA (omega-3) good predictor of survival time:
   Plantinga EA, Everts H, Kastelein AM, Beynen AC. Retrospective study of the survival of cats with acquired chronic renal insufficiency offered different commercial diets, Vet Rec. 2005 Aug 13;157(7):185-7
   
9. A fantastic article that should be a must-read for vets and caregivers alike; cogent arguments for not restricting protein. Alas, this is no longer available, but I do have this quote from it when I posted it to my forum -- "There is no evidence to believe that low protein diets are beneficial to all patients with renal azotemia (increased BUN and creatinine with isosthenuric urine specific gravity) and in fact this practice may be harmful to some patients."
   Nutritional Management of Dogs and Cats with Chronic Renal Failure - Dr. Tina Kalkstein
   
   
10. In this study, cats fed a high-protein (51.7% protein) diet had higher HCT values, weighed more, and had lower K levels (reversed with supplementation); begs the question why they fed only 0.3% K to cats with CRF when daily requirement is supposed to be 0.6% (ahem!):
    Adams LG, Polzin DJ, Osborne CA, O'Brien TD., Effects of dietary protein and calorie restriction in clinically normal cats and in cats with surgically induced chronic renal failure, Am J Vet Res. 1993 Oct;54(10):1653-62.
    
    
11. Tomohide Koizumi, Kazuya Murakami, Haruyuki Nakayama, Tomomi Kuwahara, and Yoshinari Ohnish Role of dietary phosphorus in the progression of renal failure, Biochemical and Biophysical Research Communications, Volume 295, Issue 4, 26 July 2002, Pages 917-921
    
12. Sunvold G.D., Vickers R.J., Reinhart G.A. Effect of Fermentable Fiber Blends on Nitrogen Repartitioning in the Feline, North American Veterinary Conference, Orlando, Florida, USA, January 19, 2000
    
13. Brown, Scott A., VMD, PhD, Marjorie Rickertsen, BS, Suzanne Sheldon, DVM, Effects of an Intestinal Phosphorus Binder on Serum Phosphorus and Parathyroid Hormone Concentration in Cats With Reduced Renal Function, Intern J Appl Res Vet Med Vol. 6, No. 3, 2008.