Chronic Kidney Disease (CKD) is a public health problem and World wide there is a rising incidence and prevalence of kidney failure. Increasing evidence indicates that the adverse outcomes of CKD, such as End-Stage Renal Disease (ESRD), cardiovascular disease and premature death, can be prevented or delayed when the disease is detected in time. Unfortunately, CKD is often "under-diagnosed" and "under-treated", resulting in lost opportunities for prevention. Therapeutic interventions at earlier stages are effective in slowing down the progression of CKD. The major therapeutic strategies that have been tested include strict blood glucose control in diabetes, strict blood pressure control, Angiotensin-Converting Enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARB) as well as dietary protein restriction.

The nutritional support for patients with CKD changes in phases depending on different stages of kidney disease. Especially the protein content of such a diet needs to be regularly changed over time in response to the stages of CKD:

It has been known for over 100 years that dietary protein restriction is an important part of the management of chronic kidney disease patients. Protein-restricted diets have been proposed to patients with chronic kidney disease because the reduction in alimentary protein intake improves many of the uremic symptoms and associated metabolic complications. A principle goal of well-planned, protein-restricted dietary regimen in compliant patients is to decrease the accumulation of nitrogen waste products, hydrogen ions, phosphates and inorganic ions while maintaining an adequate nutritional state.

Protein-restricted diets are associated with their beneficial effects on the progressive loss of renal function accompanied with delaying the start of renal replacement therapy with obvious medical and economic consequences.

Both, hyperfiltration of residual nephrons due to dietary protein loads and severe proteinuria are main causes for the progression of chronic kidney disease that can be limited by protein-restricted diets supplemented with amino and keto acids.Two dietary regimens have been used to treat patients with progressive CKD: