Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
For clinicians treating chronic conditions such as end-stage renal disease (ESRD), the quality of patients' lives is an important consideration. This Viewpoint highlights the ways in which health-related quality of life can be measured in ESRD (e.g. with generic instruments that facilitate comparisons with the general population and between countries), and the difficulties of such measurement. The authors offer their suggestions of how best to obtain and use this information to improve the care and outcomes of patients with ESRD.
Hospitalized patients have several stimuli for vasopressin production that increase the risk of their serum sodium concentration dropping to dangerous levels. Here, Moritz and Ayus elegantly present evidence to support their opinion that prevention and management of hyponatremia are worryingly inadequate in many institutions. They assert that fundamental changes to long-standing, but erroneous, tenets of fluid therapy are needed to prevent unnecessary deaths.
The authors analyze experimental findings which indicate that limiting protein intake protects the kidney and ameliorates uremic symptoms, outline how the body adapts to reduced protein intake, and describe the metabolic benefits for people with chronic kidney disease. Data from randomized controlled trials and meta-analyses pertaining to the effects of low-protein diets in this population are reviewed.
