Ernie Ball is a computer systems analyst. When he was 38, he visited his doctor because he had pain in his flanks. A urine test showed protein plus red cells, and his doctor told him that he had a urinary tract infection and urethral stricture. Leg swelling appeared soon thereafter. He had taken analgesics (aspirin or Anacin plus Dristan) daily for years because of headaches. By age 40, he had high blood pressure and signs of moderately severe kidney failure. At age 56, by which time his serum creatinine concentration was 6.4 mg per dl, indicating severe kidney failure, he started a supplemented very-low-protein diet. He succeeded in deferring dialysis for four more years by means of a very-low-protein, low-salt diet plus either amino acids or ketoacids, antihypertensive drugs, diuretics, calcium, zinc, iron, vitamins, and sodium polystyrene sulfonate.
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