Abstract:
BACKGROUND:Dietary protein has long been thought to play a role in the progression of chronic renal disease, but clinical trials to date have not consistently shown that dietary protein restriction is beneficial. PURPOSE:To use meta-analysis to assess the efficacy of dietary protein restriction in previously published studies of diabetic and nondiabetic renal diseases, including the recently completed Modification of Diet in Renal Disease Study. DATA SOURCES:The English-language medical literature published from January 1966 through December 1994 was searched for studies examining the effect of low-protein diets in humans with chronic renal disease. A total of 1413 patients in five studies on nondiabetic renal disease (mean length of follow-up, 18 to 36 months) and 108 patients in five studies of type I diabetes mellitus (mean length of follow-up, 9 to 35 months) were included. STUDY SELECTION:Randomized, controlled studies were selected for nondiabetic renal disease; randomized, controlled studies or time-controlled studies with nonrandomized crossover design were selected for diabetic nephropathy. DATA EXTRACTION:Data in tables, figures, or text were independently extracted by two of the authors. DATA SYNTHESIS:The relative risk for progression of renal disease in patients receiving a low-protein diet compared with patients receiving a usual-protein diet was calculated by using a random-effects model. In five studies of nondiabetic renal disease, a low-protein diet significantly reduced the risk for renal failure or death (relative risk, 0.67 [95% Cl, 0.50 to 0.89]). In five studies of insulin-dependent diabetes mellitus, a low-protein diet significantly slowed the increase in urinary albumin level or the decline in glomerular filtration rate or creatinine clearance (relative risk, 0.56 [Cl, 0.40 to 0.77]). Tests for heterogeneity showed no significant differences in relative risk among studies of either diabetic or nondiabetic renal disease. No significant differences were seen between diet groups in pooled mean arterial blood pressure (diabetic and nondiabetic patients) or glycosylated hemoglobin level (diabetic patients only). CONCLUSION:Dietary protein restriction effectively slows the progression of both diabetic and nondiabetic renal diseases.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Pedrini MT,Levey AS,Lau J,Chalmers TC,Wang PHdoi
10.7326/0003-4819-124-7-199604010-00002subject
Has Abstractpub_date
1996-04-01 00:00:00pages
627-32issue
7eissn
0003-4819issn
1539-3704journal_volume
124pub_type
杂志文章,meta分析abstract::A 45-year-old woman from Mendoza, Argentina, was severely bitten by a dog that died 4 days later. Before death, the dog was nervous, aggressive, and had occasional seizures. Ten days after the woman had been bitten, rabies vaccine treatment was begun: 14 daily doses of suckling mouse brain vaccine followed by 2 booste...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-1-44
更新日期:1976-07-01 00:00:00
abstract:BACKGROUND:Prediction of perioperative cardiac complications is important in the medical management of patients undergoing noncardiac surgery. Several indices have been developed to aid prediction, but their performance has not been systematically compared. OBJECTIVE:To compare four existing methods for predicting per...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-133-5-200009050-00011
更新日期:2000-09-05 00:00:00
abstract:PURPOSE:To evaluate the use of thyroid function tests to monitor therapy in patients taking levothyroxine. DATA IDENTIFICATION:Studies published between 1966 and January 1990 were identified through computer searches and references of identified studies. STUDY SELECTION:Studies that included a careful description of ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-113-6-450
更新日期:1990-09-15 00:00:00
abstract::Hypophosphatemic osteomalacia that remits after resection of a coexisting tumor has been described in 35 patients. Because the associated neoplasms have been of mesenchymal origin, it has been inferred that this tumor-induced osteomalacia syndrome is uniquely related to tumours of this derivation. However, in the pres...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-2-275
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND:Common diseases, particularly dementia, have large social costs for the U.S. population. However, less is known about the end-of-life costs of specific diseases and the associated financial risk for individual households. OBJECTIVE:To examine social costs and financial risks faced by Medicare beneficiaries ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-0381
更新日期:2015-11-17 00:00:00
abstract::In a prospective study, mortality ratios were computed in relation to overweight, cancer, and other diseases. The study included 750 000 men and women followed for 12 years. Each person was given a weight index. Death rates for overweight and underweight persons were compared with rates for persons of average weight. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-6-1034
更新日期:1985-12-01 00:00:00
abstract::Twenty-nine men with stage III or unresectable stage II malignant germ cell tumors and no previous chemotherapy received treatments with the VAB-6 protocol. The VAB-6 regimen is a 1-year program beginning with three successive inductions at 3-to-4-week intervals: day 1--cyclophosphamide, 600 mg/m of body surface area ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-1-59
更新日期:1981-07-01 00:00:00
abstract::Between 20 July and 15 Octoboer 1975, five cases of human infection with Babesia microti were diagnosed on Nantucket Island, Massachusetts. The illness was characterized by fever, drenching sweats, shaking chills, myalgia, arthralgia, extreme fatigue, and a mild-to-moderate hemolytic anemia. None of the patients had a...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-1-6
更新日期:1977-01-01 00:00:00
abstract::In April 1976 the attack rate of chills and fever with or without falls in blood pressure increased in association with cardiac catheterizations. Fevers were associated with coronary angiography and right and left heart catheterizations. Blood cultures were negative, and reactions did not correlate with amounts of con...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-1-32
更新日期:1980-07-01 00:00:00
abstract:BACKGROUND:Although weight loss improves risk factors for cardiovascular and metabolic disease, it is unclear whether intentional weight loss reduces mortality rates. OBJECTIVE:To examine the relationships among intention to lose weight, weight loss, and all-cause mortality. DESIGN:Prospective cohort study using a pr...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-5-200303040-00007
更新日期:2003-03-04 00:00:00
abstract::This paper outlines the clinical, serologic, and immunogenetic differences and similarities of Sjögren's syndrome alone (primary) and Sjögren's syndrome associated with rheumatoid arthritis and systemic lupus erythematosus (secondary). The immunoregulation in Sjögren's syndrome is discussed and the incidence of immune...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-212
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To determine the role of B19 parvovirus in red cell aplasia of patients infected with human immunodeficiency virus type 1 (HIV-1). DESIGN:Uncontrolled clinical trial, with assay of serum, peripheral blood cells, and bone marrow for virus using DNA hybridization and immunocytochemistry techniques; these assay...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-12-926
更新日期:1990-12-15 00:00:00
abstract::Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, bu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-6-199803150-00007
更新日期:1998-03-15 00:00:00
abstract::Between June 1980 and September 1981 we evaluated 24 cases of endocarditis from methicillin-resistant Staphylococcus aureus. All of the cases occurred in drug addicts and all were community-acquired. The patients ranged in age from 21 to 59 years and represented an older population than that generally reported for bac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-3-330
更新日期:1982-09-01 00:00:00
abstract:BACKGROUND:Warfarin reduces the risk for ischemic stroke in patients with atrial fibrillation (AF) but increases the risk for hemorrhage. Dabigatran is a fixed-dose, oral direct thrombin inhibitor with similar or reduced rates of ischemic stroke and intracranial hemorrhage in patients with AF compared with those of war...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-154-1-201101040-00289
更新日期:2011-01-04 00:00:00
abstract:BACKGROUND:Resistance to activated protein C due to the factor V R506Q (Leiden) mutation is the most common clotting abnormality in patients with venous thromboembolism. OBJECTIVE:To evaluate the risk for venous thromboembolism associated with the factor V Leiden mutation or with resistance to activated protein C in t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-8-199904200-00004
更新日期:1999-04-20 00:00:00
abstract::The sharp rise in drug abuse in the past decade has led to the development of new sources of information on drug-abuse trends. These include surveys, drug-related emergencies, drug-abuse treatment, hepatitis rates, and various types of law enforcement information. This paper summarizes data currently available for her...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-3-402
更新日期:1975-09-01 00:00:00
abstract::This issue provides a clinical overview of sickle cell disease focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. No...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-5-201109060-01003
更新日期:2011-09-06 00:00:00
abstract:BACKGROUND:Screening programs using conventional cytology have successfully reduced cervical cancer, but newer tests might enhance screening. PURPOSE:To systematically review the evidence on liquid-based cytology (LBC) and high-risk human papillomavirus (HPV) screening for U.S. Preventive Services Task Force use in up...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-10-201111150-00376
更新日期:2011-11-15 00:00:00
abstract::The new knowledge of the regulation of cell growth and the genetic and biochemical changes that lead to malignancy have created many new opportunities for cancer drug discovery. These new targets include oncogenes, growth factors and their receptors, signal transduction pathways, and cell differentiation signals. Atte...
journal_title:Annals of internal medicine
pub_type: 评论,杂志文章,评审
doi:10.7326/0003-4819-118-8-199304150-00011
更新日期:1993-04-15 00:00:00
abstract:BACKGROUND:Prospective data defining the clinical course in idiopathic pulmonary fibrosis (IPF) are sparse. OBJECTIVE:To analyze the clinical course of patients with mild to moderate IPF. DESIGN:Analysis of data from the placebo group of a randomized, controlled trial evaluating interferon-gamma1b. SETTING:Academic ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-12_part_1-200506210-00005
更新日期:2005-06-21 00:00:00
abstract:BACKGROUND:HIV-infected patients with sustained immunologic improvement from antiretroviral therapy may be able to discontinue chemoprophylaxis against Pneumocystis carinii pneumonia (PCP). OBJECTIVE:To compare PCP incidence in HIV-infected patients who had sustained CD4+ lymphocyte counts greater than 200 cells/mm3 a...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-3-200002010-00005
更新日期:2000-02-01 00:00:00
abstract::Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating di...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-6-800
更新日期:1983-12-01 00:00:00
abstract::Breast cancer is the major cancer killer of women in the United States. Recent advances in therapy promise more effective control of this illness. The development of hormone receptor analysis permits us to better understand the mechanisms of action of steroid and peptide hormones and increases the likelihood of using ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-784
更新日期:1977-06-01 00:00:00
abstract::The frequency of solid tumors was evaluated in 628 consecutive patients with multiple myeloma who had been treated with various melphalan-prednisone combinations. Among those patients who lived at least 2 months, the incidence and diversity of second tumors were similar to those in normal persons of the same age and d...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-5-780
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:Four months of rifampin treatment for latent tuberculosis infection is safer, has superior treatment completion rates, and is as effective as 9 months of isoniazid. However, daily medication costs are higher for a 4-month rifampin regimen than a 9-month isoniazid regimen. OBJECTIVE:To compare health care us...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M19-3741
更新日期:2020-08-04 00:00:00
abstract::Sixty-eight patients clinically suspected of having (33), or at high risk for (35), deep venous thrombosis were studied with contrast venography, radiofibrinogen leg scanning, and impedance plethysmography as well as ventilation and perfusion lung scans. Thrombosis limited to the veins in the calf of the leg (unilater...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-4-439
更新日期:1981-04-01 00:00:00
abstract::The Federated Council for Internal Medicine (FCIM) comprises the American Board of Internal Medicine, American College of Physicians, American Society of Internal Medicine, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, and the Society of General Internal Medicine. The Co...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章
doi:10.7326/0003-4819-117-9-778
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVE:To describe the relation between glycated hemoglobin and the incidence or progression, or both, of diabetic microvascular complications in persons with insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). DESIGN:Population-based on cohort study. SETTING:An 11-county area in southern...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-1_part_2-199601011-00003
更新日期:1996-01-01 00:00:00
abstract:Background:More than half of enrollees in the U.S. Department of Veterans Affairs (VA) are also covered by Medicare and can choose to receive their prescriptions from VA or from Medicare-participating providers. Such dual-system care may lead to unsafe opioid use if providers in these 2 systems do not coordinate care o...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M18-2574
更新日期:2019-04-02 00:00:00