The Effect of Diet on the Survival of Patients with Chronic Kidney Disease

Abstract

The prevalence of chronic kidney disease (CKD) is high and it is gradually increasing. Individuals with CKD should introduce appropriate measures to hamper the progression of kidney function deterioration as well as prevent the development or progression of CKD-related diseases. A kidney-friendly diet may help to protect kidneys from further damage. Patients with kidney damage should limit the intake of certain foods to reduce the accumulation of unexcreted metabolic products and also to protect against hypertension, proteinuria and other heart and bone health problems. Despite the fact that the influence of certain types of nutrients has been widely studied in relation to kidney function and overall health in CKD patients, there are few studies on the impact of a specific diet on their survival. Animal studies demonstrated prolonged survival of rats with CKD fed with protein-restricted diets. In humans, the results of studies are conflicting. Some of them indicate slowing down of the progression of kidney disease and reduction in proteinuria, but other underline significant worsening of patients’ nutritional state, which can be dangerous. A recent systemic study revealed that a healthy diet comprising many fruits and vegetables, fish, legumes, whole grains, and fibers and also the cutting down on red meat, sodium, and refined sugar intake was associated with lower mortality in people with kidney disease. The aim of this paper is to review the results of studies concerning the impact of diet on the survival of CKD patients.

Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: a mixed-methods survey

“…This raises concerns on the wellbeing and clinical stability of the CKD patients including the risk of co-morbidities. For the CKD patients on hemodialysis, limiting the intake of certain foods is important in order to reduce the accumulation of metabolic wastes in the blood as well as reduce the development of comorbidities such as hypertension and other health complications [11].…”

“…Dietary adaptations for key nutrients, particularly carbohydrates, proteins, sodium, potassium, phosphorus, and fluid intake, are necessary to reduce the risk for morbidity and mortality in patients with CKD [10]. For patients on hemodialysis, limiting the intake of certain foods is important in order to reduce the accumulation of these metabolic wastes in the blood and to reduce the development of comorbidities such as hypertension, proteinuria, and other health complications of the heart and bones [11]. The dietary restrictions are recommended to prevent deterioration of kidney functions and thus slowing down the risk for morbidity and mortality [10].…”

Could Low-Protein Diet Modulate Nrf2 Pathway in Chronic Kidney Disease?

“…Indeed, LPD is one of the most important therapeutic strategy proposals for CKD 3-4 patients as it has been shown to result in reduced CKD progression rate and other benefits like improvement of oxidative stress and inflammation. [60][61][62][63] These benefits are mainly due to the reduction of proteinuria, but also to prevention of hyperphosphatemia, reduced dietary acid load, and improved lipid profile. It could also be hypothesized that LPD modulates the gut microbiota and reduce the generation of uremic toxins, such as p-cresyl sulfate (PCS) and indoxyl sulfate (IS).…”

Inflammation and Chronic Kidney Disease: Current Approaches and Recent Advances

“…The significance of a proper diet was settled in large retrospective cohort studies, which evidenced that the mortality occurrence in predialysis patients that were under dietitian surveillance decreased 19% compared with the patients not under any dietary treat. The conclusion that emerged is that a nutritional care in early stages of CKD could have a better prognosis on survival; however, randomized clinical trials are needed to prove this hypothesis [81].…”