Abstract
Vegetable protein diets (VPDs) in chronic kidney disease (CKD) patients may be related to beneficial biological actions and possibly clinical impact. This is a scoping review that merge studies that evaluated the effect of a vegetarian diet on kidney function in adults with CKD under non-dialysis treatment. The evaluated outcome was the impact in renal function assessed by eGFR or creatinine clearance. MEDLINE (accessed by PubMed) was searched up to September 8, 2020. Data were extracted by two independent reviewers, who also assessed the quality of the studies. Of 341 retrieved articles, 4 studies assessing 324 patients were included in the analysis. One study showed that a very low-protein ketoanalogue-supplemented vegetarian diet had benefits in relation to a conventional low-protein diet, while the other three studies demonstrated no difference in kidney function between the evaluated diets. Additional studies are needed to assess the benefits of vegetarian diets for further recommendations in CKD management.
Highlights
Chronic kidney disease (CKD) is defined by a decreased renal function, that is, a glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2, or markers of kidney damage, or both, for at least 3 months, regardless of the underlying cause
Studies comparing a vegetarian to a non-vegetarian diet in adults with CKD in non-dialysis treatment were included
The results of this review indicate that it is likely that a very low-protein ketoanalogue-supplemented vegetarian diet could have benefits in patients with advanced CKD11
Summary
Chronic kidney disease (CKD) is defined by a decreased renal function, that is, a glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2, or markers of kidney damage, or both, for at least 3 months, regardless of the underlying cause. The National Kidney Foundation recommends protein restriction with or without keto acid analogs for adults with CKD 3-5 without diabetes who are metabolically stable and under close clinical supervision, to Vegetarian diets and CKD reduce the risk for end-stage kidney disease (ESKD) and death and improve their quality of life[3]. For these patients, the protein intake level can be safely decreased to 0.55 to 0.6 g protein/kg per day[3]. In adult diabetic patients with CKD 3-5, a dietary protein intake of 0.6–0.8 g/kg body weight per day is recommended to maintain a stable nutritional status and optimize glycemic control[3]
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