IT is now more than 30 years since Addis suggested that protein intake be restricted in patients with chronic renal insufficiency.¹ His aim was not to reduce uremic symptoms but rather to prevent an increase in the "workload" of surviving nephrons of diseased kidneys in order to minimize further loss of renal function. With the development and increasingly widespread availability of dialysis and transplantation in the past three decades, relatively little attention has been paid to the influence of diet on the progression of renal disease, despite general awareness that renal disease typically follows an inexorably progressive course. In this . . .