Currently in western medicine, it is believed that nephritis is caused by a variety of health conditions ranging from acute infections to autoimmune disorders. Modern therapies include corticosteroids, immunosuppressant drugs, antibiotics, plasmapheresis, renal dialysis, and kidney transplants. Corticosteroids reduce inflammation of the kidneys and immunosuppressant drugs are prescribed to limit the immune response that causes the inflammation. If the cause of an individual’s nephritis is known to be bacterial, antibiotics are administered. In severe cases that progress rapidly to kidney failure or end stage kidney disease, plasmapheresis, renal dialysis, and kidney transplants are prescribed.
The exact cause of Linus Pauling’s nephritis is unknown. While Thomas Addis’s low-sodium, low-protein diet appears to have been successful in Pauling’s treatment, his radical dietary therapy for nephritis lost popularity within the United States shortly after Dr. Addis’s death. The dietary treatment was quickly replaced with steroid therapies and renal dialysis.
The medical community seems to have lost interest in Dr. Addis’s dietary therapy until an article was published in the New England Journal of Medicine in 1982. With a fresh outlook on the potential of a low-protein diet in the treatment of glomerulonephritis, the medical community’s consideration of Addis’s dietary regimen peaked once again.
The primary author of the 1982 publication, Dr. Barry Brenner, further developed Addis’s theory, providing additional insight into the progression of damage to the glomeruli caused by nephritis.
Using rats as a model, Brenner determined that upon the onset of damage to the glomeruli (the small capillaries), all remaining healthy glomeruli begin overcompensating for the lost filtration function. By elevating internal pressure, filtration through the remaining functioning glomeruli increases. This overcompensation has severe consequences on the healthy glomeruli. As the healthy glomeruli continue to compensate they undergo increased stress causing wear-and-tear on their structure, which ultimately results in additional damage to the remaining functioning glomeruli. Brenner termed this form of compensation “hyperfiltration.”
In revisiting Addis’s proposed low-protein remedy, Brenner and his laboratory team determined that a protein-restricted diet reduces the kidneys’ overall workload, and thus decreases the stress caused by such hyperfiltration. Since the consumption of proteins increases the amount of filtration required of the kidneys, a low-protein diet reduces the kidneys’ workload and thereby decreases further damage to the remaining healthy glomeruli.
Brenner’s work was well received and current treatment plans, once again, often include dietary restriction of protein, sodium, and potassium, in addition to the other aforementioned modern therapies. Whether commonly recognized or not, Thomas Addis’s pioneering research on diseases of the kidney – research which, in the early 1940s, saved Linus Pauling’s life – is still making an impact today.