The uraemic syndrome results from an inability
of the kidney to excrete nitrogenous waste products including urea, and other toxins.
Reduction of dietary intake of protein reduces the quantity of circulating proteinaceous waste products and has been shown in many studies in rats, people and dogs to result
in marked clinical improvement, increased survival and preserved renal function.
A comprehensive reference list has been published (Lewis et al. 1987).
It has been shown that people (Walser & Mitch 1977) and dogs (Osborne 1980) with
renal failure have a higher requirement for protein than normal individuals and the
amount of protein needed will depend upon the severity of the renal dysfunction and
the digestibility and quality of the protein in the food. The aim therefore is to
feed sufficient high biologic value protein to meet the animal's requirements, but
to maintain a blood urea level of 60 mg/dl (10 mmol/l) or less. Approximations of
the amount of protein needed in dogs with renal failure to achieve this have been
published (see Table 5.1).
Clinical signs attributable to uraemia should be controlled at a BUN of less than