Comparison of a Vegetable-Based (Soya) and an Animal-Based Low-Protein Diet in Predialysis Chronic Renal Failure Patients

Abstract

There is some experimental evidence to suggest that progression of chronic renal failure (CRF) is slower on diets based on soya protein than on diets based on animal protein. We have compared the effect of a soya-based vegetarian low-protein diet (VPD) and an animal-based low-protein diet (APD) in 15 patients with CRF. 15 patients with CRF (⁵¹Cr-EDTA-measured glomerular filtration rate 15–50 ml/min/1.73 m²) were studied. In a randomized crossover trial, the patients were given each diet (each containing 0.75 g protein and 32 kcal per kilogram body weight) for a 6-month period. Nine patients completed the trial, 2 others dropped out because they could not tolerate the VPD, 3 because of unrelated medical complications, and 1 for technical reasons. The caloric intake was higher and the protein, phosphate and essential amino acid intake lower on the VPD than on the APD. The compliance with the suggested caloric intake was better with the VPD than with the APD (97 vs. 88% of recommended intake), as was the compliance with the suggested protein intake (94 vs. 112% of recommended intake) and with the suggested phosphate intake (102 vs. 116%). The mean glomerular filtration rate, as judged by ⁵¹Cr-EDTA, was similar after 6 months on each diet and remained unchanged throughout the entire year of the study. The rate of fall of glomerular filtration, as measured by the slope of 1/serum creatinine was slowed by 73% during the 1-year study period as compared with the prestudy period. Nutritional status (as measured by body mass index, midarm circumference, and lean body mass and percent body fat), serum transferrin, cholesterol and albumin, and total lymphocyte count were similar on the two diets. The serum albumin level on both diets, however, was significantly higher on the two diets than during the prediet period. Blood urea nitrogen, urine urea nitrogen, protein catabolic rate, and 24-hour urine creatinine and phosphate were lower on the VPD than on the APD. The 24-hour protein excretion was similar on the two diets. The two low-protein diets resulted in a slowing in the progression of CRF. A VPD is well tolerated in CRF and is associated with lower protein and phosphate intakes and a higher caloric intake than an APD and may, therefore, be used as a safe alternative or partial substitute for the usual APD in CRF.

Short-term effects of soy protein diet in patients with proteinuric glomerulopathies

“…Some studies show positive results 12,[25][26][27][28] and others show negative. 12,29,30 Studies performed in healthy subjects have demonstrated that substituting the APD by one of vegetal origin was efficient to prevent the proteinuric and hyperfiltration related effects of meat, which could be very advantageous in the treatment of subjects with chronic renal disease. 13,31 On the contrary, Kitazato et al 30 have evaluated the effect of a diet with elevated amount of vegetal protein and reduced content of animal protein and vice versa in healthy subjects, and they have not observed any difference of those diets on renal function and 24-hour urinary albumin excretion.…”

“…Soroka et al 29 have evaluated the effect of a lowprotein diet with vegetal protein compared to a lowprotein diet with animal protein in subjects with chronic renal failure, in a period of six months, and observed that although the vegetal protein diet had warranted better blood urea nitrogen levels, lower protein catabolic rate and lower 24-hour urinary levels of creatinine and phosphate, the urinary excretion of protein was similar in both diets. Serum levels of transferrin, albumin, and cholesterol were also similar.…”

The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency

“…The authors of this meta-analysis suggested that benefits of a low-protein diet might be more apparent with longer follow-up. Some experimental evidence also suggests that animal proteins may play a greater role in the progression of renal disease than vegetable proteins (14 -16), but not all studies have confirmed these results (17). In experiments in humans, meat protein acutely increases GFR compared with dairy protein (18).…”

The Effect of Cost Effective and Useful Diets on Blood Parameters in Female Mice

“…In the studies of Soroka [20], Anderson [21] and Hanna et al [22] the effect of soy consumption did not decrease serum creatinine in the blood. The reduction of urinary creatinine level was somewhat unexpected, and this may approve the theory of researchers that reported the urine creatinine excretion [23].…”