Abstract

Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.

Highlights

  • Chronic kidney disease (CKD) affects almost 10% of the world’s population [1] and was the sixteenth leading cause of death globally in 2017 [2]

  • Given that eggs are a major source of high biological value (HBV) proteins and their cholesterol content may no longer be a concern in relation to cardiovascular disease (CVD) risk, we have evaluated their role in the CKD population and discuss potential benefits, limitations and adverse effects of the consumption of eggs by end-stage renal disease (ESRD) patients, as well as provided suggestions for further research

  • We provide an overview of the nutrients and bioactive egg compounds in eggs and their potential contribution to health outcomes in individuals with CKD

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Summary

Introduction

Chronic kidney disease (CKD) affects almost 10% of the world’s population [1] and was the sixteenth leading cause of death globally in 2017 [2]. Current data suggest that dietary cholesterol, in addition to increasing LDL-C, raises high density lipoprotein cholesterol (HDL-C), increases the less atherogenic large buoyant LDL, may improve HDL functionality, and minimally affects the ratio of LDL-C/HDL-C Consistent with these changes in lipoproteins, recent epidemiological studies fail to show any significant impact on CVD risk, with the possible exception of individuals with diabetes [25,27]. Given that eggs are a major source of HBV proteins and their cholesterol content may no longer be a concern in relation to CVD risk, we have evaluated their role in the CKD population and discuss potential benefits, limitations and adverse effects of the consumption of eggs by ESRD patients, as well as provided suggestions for further research. We review potential associations between egg consumption and the risk of developing CKD

Conclusion
Non-CKD Population
CKD Population
Phospholipids
Lutein and Zeaxanthin
Vitamin D
Protein
Phosphorus and Phosphorus-to-Protein Ratio
Nutrient Recommendations in CKD
Egg Supplementation Studies
Egg Intake and Risk of Developing CKD
Dietary Quality
Findings
Summary
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