The impact of a vegetarian diet on chronic kidney disease (CKD) progression – a systematic review

Abstract

Background A vegetarian diet is a popular alternative to the casual diet - it is considered healthy, and was proven to positively affect cardiovascular health. The Chronic Kidney Disease (CKD) progression is a major issue in the healthcare system, and constitutes a leading cause of death for 1.5% of the global population. The objective of this systematic review was to investigate the potential impact of a vegetarian diet on kidney function in CKD patients. Method Our systematic review focused on randomized controlled trials (RCTs) which compared the effects of a vegetarian diet (experimental) and a standard omnivore diet (comparator) in terms of the estimated glomerular filtration rate (eGFR) in CKD patients. Inclusion criteria were based on PICO elements, with two researchers involved in browsing the Cochrane and Pubmed search engines. The investigation was performed using the PRISMA 2020 Checklist and PRISMA 2020 flow diagram. The search terms included: ‘vegetarian diet’ AND ‘nephropathy’, ‘eGFR’, ‘albuminuria’, ‘chronic kidney disease’. Bias assessment was performed using RoB 2 tool to determine the validity of the data collected from studies. Results Four RCTs with a total of 346 participants were included in the presented systematic review. Two largest RCTs reported an increase in eGFR following a change to a vegetarian diet (p = 0.01 and p = 0.001). Another two found no significant differences between the experimental and control groups, also these trials were associated with a high risk of bias in terms of missing data outcome and the randomization process. Conclusions The findings collected in this systematic review suggest that a vegetarian diet improves renal filtration function in CKD patients. Therefore, it seems essential to conduct further research involving the impact of the diet on the progression of CKD.

Plantas para tus riñones: una revisión narrativa sobre la dieta basada en plantas y la enfermedad renal crónica

“…Sin embargo, la preservación de la TFG se ha puesto en debate debido a que existe evidencia de que la DBP no solo ralentiza la disminución de la TFG, sino también mejora la función de filtración renal en pacientes con ERC (p= 0,001) (20) .…”

Biotics (Pre-, Pro-, Post-) and Uremic Toxicity: Implications, Mechanisms, and Possible Therapies

“…Dysbiosis may result from factors like dietary habits, medications, physical activity, and underlying health conditions, further impacting kidney function and disease progression [64,65]. Nonetheless, both vegetarian and omnivore diets have their advantages and challenges when it comes to their impact on kidney affections, such as uremia and CKD [66]. A well-balanced vegetarian diet, rich in plant-based nutrients and carefully planned to ensure adequate protein intake, can be beneficial for managing CKD and reducing the risk of uremic toxin formation.…”

“…These compounds intervene in the Maillard reaction mechanism (the reaction between reducing sugars and amino acids that occurs during food treatments at high temperatures). Uremic products obtained from this reaction are fructose-lysine, 3deoxyglucosone, glyoxal, methylglyoxal, pentosidine, Nε-carboxymethyl lysine, and Nε- Nonetheless, both vegetarian and omnivore diets have their advantages and challenges when it comes to their impact on kidney affections, such as uremia and CKD [66]. A wellbalanced vegetarian diet, rich in plant-based nutrients and carefully planned to ensure adequate protein intake, can be beneficial for managing CKD and reducing the risk of uremic toxin formation.…”

“…Nonetheless, both vegetarian and omnivore diets have their advantages and challenges when it comes to their impact on kidney affections, such as uremia and CKD [ 66 ]. A well-balanced vegetarian diet, rich in plant-based nutrients and carefully planned to ensure adequate protein intake, can be beneficial for managing CKD and reducing the risk of uremic toxin formation.…”

Vegetarian Nutrition in Chronic Kidney Disease

“…Existing clinical trial data have also shown that partial replacement of animal protein with plant protein leads to reductions in albuminuria [ 49 , 65 , 66 ]. Finally, a recent systematic review suggested that a vegetarian diet improves renal filtration function in CKD patients [ 67 ].…”