Adequacy of Plant-Based Proteins in Chronic Kidney Disease

Joshi, Shivam; Shah, Sunil Kumar; Kalantar-Zadeh, Kamyar

doi:10.1053/j.jrn.2018.06.006

Cited by 74 publications

(59 citation statements)

References 60 publications

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“…Evidence suggests that safety and adherence to an LPD is equivalent to a normal protein diet and that there is no risk of the malnutrition or PEW that might occur with very-low protein diets (DPI 0.3-0.6 g/kg/day), even sans supplementation with essential amino acids or their keto-analogues [28]. However, while most studies suggest that an LPD ameliorates CKD progression, there are also some mixed findings [33,34], including the primary analyses of the Modification of Diet in Renal Disease (MDRD) study. Most trials except for the MDRD were small, used surrogate endpoints, were considered less rigorous compared to MDRD, used dietary interventions that were labor-intensive, were not patient-centered, and were not aligned with contemporary culture of more plant-based sources.…”

Section: A Low Protein Diet Preserves Kidney Functionmentioning

confidence: 99%

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

et al. 2020

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Chronic kidney disease (CKD) affects >10% of the adult population. Each year, approximately 120,000 Americans develop end-stage kidney disease and initiate dialysis, which is costly and associated with functional impairments, worse health-related quality of life, and high early-mortality rates, exceeding 20% in the first year. Recent declarations by the World Kidney Day and the U.S. Government Executive Order seek to implement strategies that reduce the burden of kidney failure by slowing CKD progression and controlling uremia without dialysis. Pragmatic dietary interventions may have a role in improving CKD outcomes and preventing or delaying dialysis initiation. Evidence suggests that a patient-centered plant-dominant low-protein diet (PLADO) of 0.6–0.8 g/kg/day composed of >50% plant-based sources, administered by dietitians trained in non-dialysis CKD care, is promising and consistent with the precision nutrition. The scientific premise of the PLADO stems from the observations that high protein diets with high meat intake not only result in higher cardiovascular disease risk but also higher CKD incidence and faster CKD progression due to increased intraglomerular pressure and glomerular hyperfiltration. Meat intake increases production of nitrogenous end-products, worsens uremia, and may increase the risk of constipation with resulting hyperkalemia from the typical low fiber intake. A plant-dominant, fiber-rich, low-protein diet may lead to favorable alterations in the gut microbiome, which can modulate uremic toxin generation and slow CKD progression, along with reducing cardiovascular risk. PLADO is a heart-healthy, safe, flexible, and feasible diet that could be the centerpiece of a conservative and preservative CKD-management strategy that challenges the prevailing dialysis-centered paradigm.

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Section: A Low Protein Diet Preserves Kidney Functionmentioning

confidence: 99%

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

et al. 2020

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“…However, other metrics including ''protein digestibility-corrected amino acid score'', which is the preferred method by the Food and Agricultural Organization and the World Health Organization and also gives a high score to plant-based sources such as soy protein concentrate, may be a more appropriate measure of protein quality. 9 In this issue of the Journal of Renal Nutrition, Joshi et al 9 provide a table depicting the protein digestibility-corrected amino acid score of common foods and a helpful discussion on applicability of the scoring system.…”

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confidence: 99%

Does Kidney Longevity Mean Healthy Vegan Food and Less Meat or Is Any Low-Protein Diet Good Enough?

Kalantar-Zadeh

Moore

2019

Journal of Renal Nutrition

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“…Approximately 80% of dietary phosphorus is absorbed from animal-based phosphorus, compared with 30-40% absorption from plant-based sources [110]. Additionally, hyperkalemia can adversely affect the nerves, muscles, and heart, and must be closely monitored in CKD patients with an eGFR of <30 mL/min/1.73 m 2 [111]. Serum potassium levels may be better regulated on a plant-based diet with CKD than on a regular diet since potassium from plants promotes intracellular potassium distribution.…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

“…Further, high fiber plant-based diets promote increased fecal potassium excretion, thereby preventing elevated potassium levels [109]. Although plant-based diets are typically higher in potassium, they do not promote hyperkalemia in clinical studies [111].…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

Sterling

2019

Nutrients

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Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic diseases. Further, attention must be given to the unique individual, familial, communal, and environmental needs that Blacks who follow plant-based diets may have. Interventions must be culturally appropriate in order to achieve long-term success, and providing low-cost, flavorful, and nutritious options will be important.

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Adequacy of Plant-Based Proteins in Chronic Kidney Disease

Cited by 74 publications

References 60 publications

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease

Does Kidney Longevity Mean Healthy Vegan Food and Less Meat or Is Any Low-Protein Diet Good Enough?

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

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