Die diätetische Therapie bei Nierenerkrankungen ohne arterielle Hypertonie und Einschränkung der Nierenfunktion ist heute weit-gehend verlassen worden. Arterielle Hypertonie, Urämie, Kalk- und Uratsteine bedürfen dagegen einer spezifischen Therapie. Symptome des Urämiesyndroms sind zumindest teilweise auf Störungen im Aminosäurenstoffwechsel bei Niereninsuffizienz zurückzuführen, wie tierexperimentelle Befunde zeigten. Urämiepatienten mit Störungen im Plasmaproteinstoffwechsel (Transferrin, Komplement, Cholinesterase, retinolbindendes Protein, Präalbumin) bedürfen einer oralen bzw. parenteralen Substitution essentieller Aminosäuren. Dies gilt vor allem im akuten katabolen Streβ bei Niereninsuffizienz mit und ohne Dialysebehandlung.

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