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The optimum performance of the conservative therapy of the chronic renal insufficiency demands a good cooperation between the patients, the dietician and the physician. The foundation of centres of the nephrological care for patients with renal insufficiency guarantees the possibility of a continuous control. In the conservative therapy the measures in question are symptomatic ones, excluding the medicamentous therapy of the basic disease in acute episodes. The dietetic measures are the basis of the conservative therapy. The diet moderately poor in protein should be given at creatinine values in the serum 4 mg/100ml and the diet strongly poor in protein from 8 mg/100 ml (prophylactically perhaps from 6 mg/100 ml). In the dietetic measures apart from the protein restriction the calorie intake (35 to 40 calories/kg body weight a day), the intake and output of fluids and the electrolyte metabolism as well as the vitamin intake should particularly be taken into consideration. Additional symptomatic medicamentous measures are necessary in order to improve the clinical symptomatology of the chronic renal insufficiency. By means of the conservative therapy the period to the necessary dialytic treatment can be delayed. Apart from this a lengthening of life and an improvement of the rehabilitation is possible in those patients, in whom an active therapy is not taken into consideration.

Within the research project nutrition and performance on altogether 80 test persons during a three weeks' test period the problem was examined, whether the relations of the basal nutrients have an influence on the effectiveness of a diet with an only moderate reduction of calories. The relations of the nutrients were tested in four variants. The daily caloric intake orients at the optimum weight of the test person: 30 kcal/kg optimum weight a day. It was shown that the so-called optimum weight caloric diet led to a sufficient continuous decrease of weight without disturbances of the general state of health. The variation of the relations of the basal nutrients had no decisive influence on the effectiveness.

Extreme caloric reduction diets with a daily content of calories of less than one third of the calories calculated with regard to the optimum weight (per kg optimum weight 30 kcal are used) lead principally to the same changes as the initial diet. Only in a daily addition of calories of at least one third of the calories calculated to the optimum weight no further loss of protein takes place, and scarcely appear side-effects. Thus the limit of the riskless reduction for adults is marked, when at the same time all essential constituents of nutrition are given in a sufficient quantity. A diet called metabolic basic diet (protein 20 kcal%, fat 35 kcal%, carbohydrates 45 kcal%, linoleic acid 20% of the total proportion of fats, cholesterol 400 mg a day, purine-N 200 mg a day, dissaccharides 10% of the carbohydrate addition) decreases or normalises risk factors depending on nutrition such as hyperlipoproteinaemia and hyperuricaemia in a constancy of body-weight. In simultaneous caloric reduction the effect on risk factors depending on nutrition is practically identical with that one of a normal diet calorically reduced in the same extent.

The reasons for a transformation of the dietary therapy in gastroenterologic diseases are in the reduction of forms of mild diet related to organs (mild diet for stomach, intestine, liver and gall-bladder), which are based on connections between complaints and organic diseases no more up to date. In their place enters the gastroenterologic basis diet which, according to the course of the diseases (subacute, chronic) is represented in two steps as strong and dilated basic diet. The displacement of the emphasis of multifarious formed of.

Issuing from the present state of the influence of the basic nutritive substances (protein, fat, carbohydrates) and various nutritive factors discussed again and again (cholesterol, erucaic acid, sodium, calcium/magnesium quotient, pressor amines) on the development of the arteriosclerosis, the indididual factors of influence are critically evaluated. The investigations are getting under way, so that ascertained results are standing beside insufficiently claified or open problems, From the abundance of the observations conclusions are drawn which are of significance for practice. Unfavourable influences of nutrition on the factors of risk (hyperlipoproteinaemia, disturbance of the carbohydrate tolerance, hyperuricaemia, hyperalimentation) and on the manifest diseases (hypertension, diabetes mellitus, uric arthritis, obesity) of the metabolic syndrome which finally contribute to the development of arteriosclerosis are emphasized. In front of this background a clinically and ambulatorily tested basic metabolic diet is described. About 20% of the energy content (kcal or kJ) of this diet are protein, 35% fat and 45% are carbohydrates. The saturated fatty acids lie below 30%, the manifold saturated fatty acids, however, above 20% of the total fat proportion. The cholesterol content is below 400 mg, the purin-nitrogen below 200 mg, and the sodium content is about 2g per day. This diet can be produced for the treatment of persons with normal weight and overweight in different energetic degradations.