So far, there is no specific treatment for chronic renal insufficiency (also known as chronic renal failure), and in addition to lowering blood pressure to meet the standard, low-protein diet therapy is particularly important; low-protein diet not only reduces the symptoms of uremia, but also may slow down the progression of kidney disease, and even helps in the control of renal hypertension; however, due to the popularity of dialysis treatment methods since the 1980s, and the However, due to the widespread acceptance of dialysis treatment methods since the 1980s, coupled with the general lack of low-protein foods used for low-protein diet therapy, the poor taste of a single variety, and the fact that low-protein diet therapy is a method that requires long-term patient adherence to achieve therapeutic effects, as well as the lack of good cooperation among physicians, dietitians and patients’ families, resulting in poor patient compliance with low-protein diet therapy, it is difficult to reflect the efficacy of this therapy, thus affecting the This has affected the progress and application of low-protein diet therapy, especially in the late 1990s, when the MDRD was misleading due to inaccurate results caused by design flaws, making the nephrology community even less confident in low-protein diet therapy. In 1999, the author was awarded the Ministry of Health G Kawasaki Medical Scholarship to study this topic for one year in Japan under the supervision of Professor Izuru Shoguni, during which more than 5000 cases of low protein diet therapy were observed in clinical practice. I. The benefits of low protein diet in the treatment of chronic renal failure. From the 1920s, it was recognized that a low-protein diet could reduce the symptoms of uremia and improve acidosis by reducing nitrogen intake, and a large number of animal experiments and clinical studies in the 1970s and 1980s found that low-protein diet therapy could delay or even prevent many metabolic complications caused by uremia, such as metabolic acidosis, calcium and phosphorus metabolism disorders, secondary hyperparathyroidism, improve lipid metabolism disorders and insulin resistance. The new study found that low-protein diet also contributes to the antihypertensive treatment of chronic kidney disease. Through long-term low-protein diet therapy education, when patients enter dialysis treatment, their performance is more stable and their quality of life is higher than that of patients who did not receive low-protein diet therapy before dialysis. Second, nephrologists and dietitians’ perception of low protein diet. One school of thought, represented by Mitch and Kopple, believes that every patient with renal failure should be treated with a low-protein diet because it not only reduces the symptoms of uremia, but also may delay the progression of renal insufficiency, and recent studies have found that patients who have been treated with a low-protein diet, when Another view is that nowadays, dialysis treatment is generally accepted and low-protein diet therapy is difficult to implement and its efficacy has not been determined, so it is not important to give low-protein diet therapy to patients with chronic renal failure. The author believes that under the present economic conditions in China, the status of low protein diet in renal disease treatment should be emphasized and vigorously promoted. First, let patients understand the important role of low protein diet in treatment. The main difficulty in the implementation of low-protein diet therapy is the poor compliance of patients due to psychosocial factors, regional living habits and dietary habits, and patients’ lack of awareness of the importance of low-protein diet therapy; therefore, to break through this problem, we have to start from these aspects. The author has gained a lot from years of clinical practice. When patients come to the clinic, they should first be made to understand their condition and be informed that when renal function declines to 50% of normal, the progress of renal function is irreversible. So far, in addition to lowering blood pressure to control the standard, the most important treatment is low protein diet treatment. The earlier the low-protein diet is started, the better the effect will be, that is, when the chronic glomerulonephritis part of the glomerulus destruction, the rest of the glomerulus in high pressure, high perfusion and high filtration state should start low-protein diet therapy, animal and human experiments have confirmed that the low-protein diet can reduce the glomerulus “three high” state. This is one of the most important theories for the progression of chronic renal insufficiency. Fourth, educate patients about protein-containing foods. The author’s mentor, Professor Shigekuni Izura of Showa University in Japan, has been educating patients about low-protein diet therapy since 33 years ago, and the “Kidney Disease Classroom” organized by him has been reported in major media throughout Japan. They also have a dietitian who regularly teaches and shares how to make their own delicious low-protein nutritional therapy meals with low-protein ingredients (called cooking class). Through several years of clinical practice and patient education, I learned that the current national population does not know enough about diet structure and food composition, which is very important for the implementation of low-protein diet therapy, especially whether the treatment can get effective cooperation from patients; therefore, when we implement low-protein diet therapy for patients, we have to repeatedly educate patients about food composition, especially with the cooperation of dietitians, individually or by organizing lectures Through three years of efforts, most of the author’s patients with chronic renal failure are now able to receive low-protein diet therapy. V. How to implement low protein diet for patients? In recent years, I have worked closely with the dietitian to educate patients patiently and meticulously on how to implement a low-protein diet, teaching them to stop eating out (restaurant meals) and buying finished foods, and to prepare special meals in strict accordance with the food composition and dosage instructed by the doctor and the dietitian. Then, the physician and dietitian regularly monitor the patient’s compliance with treatment, mainly by asking the patient’s dietary records and estimating the patient’s protein intake through urine excretion of non-protein nitrogen, and then providing feedback to the patient so that the patient can further adjust his or her diet until it meets the physician’s prescribed standards. When I was studying in Japan, I saw that some patients had to bring two meals from home to Tokyo from Hokkaido, the northernmost part of Japan, and when asked why, the answer was that the doctor had ordered not to eat in outside restaurants. For patients with chronic kidney disease receiving low-protein nutrition therapy, follow-up visits must be strengthened (at least once a month). Doctors and dietitians regularly ask patients about their dietary records and non-protein nitrogen excreted through urine to calculate their actual protein intake, give feedback to patients, and instruct them to make dietary adjustments. At the same time, the patient’s nutritional status indicators, including weight, subcutaneous fat thickness, total serum protein, albumin, prealbumin and hematocrit, are monitored on a follow-up basis to avoid malnutrition. Sixth, China’s future in the low-protein diet treatment needs to be addressed: 1, make great efforts to develop low-protein food, because the main reason for the poor compliance of patients with low-protein diet treatment over the past half century is because the application of low-protein food varieties in the implementation of treatment, poor taste, it is difficult for patients to adhere to long-term use; currently Japan is more advanced in this regard, their low-protein food has been factory production At present, Japan is more advanced in this regard, and their low-protein foods have been factory-produced, with a full range of patterns and varieties to suit patients with different living habits, and in recent years they have developed low-protein rice for clinical use. 2.Strengthen the basic experimental research of low-protein nutrition therapy to promote the development of clinical treatment and the improvement of treatment level. 3.Strengthen the propaganda of low protein diet therapy so that doctors, dietitians, patients and families have a correct understanding of the therapy and actively cooperate with each other to complete the treatment. 4.Cultivate a group of specialized nephrologists who aspire to engage in clinical nutrition therapy to cooperate with doctors. 5. Accelerate the update of food composition label in China and popularize the application in hospital nutrition room.