Abstract: FR-PO1049
Effects of Type of Protein Intake on Risk of Kidney Disease Progression among Patients with Nondialysis-Dependent CKD: A Systematic Review
Session Information
- Kidney Nutrition and Metabolism
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Wong, Michelle M.Y., University of British Columbia, Vancouver, British Columbia, Canada
- Renouf, Dani, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Borkum, Megan, University of British Columbia, Vancouver, British Columbia, Canada
- Simms, Emily Lauren L., University of British Columbia, Vancouver, British Columbia, Canada
- Huang, Nicole, Fraser Health Authority, Surrey, British Columbia, Canada
- Levin, Adeera, University of British Columbia, Vancouver, British Columbia, Canada
Background
While diets restricted in protein quantity are recommended by kidney nutrition guidelines, the effect of the type of protein on CKD progression is not known. Thus, we performed a systematic review to assess the effects of plant-based diets on CKD progression.
Methods
We searched MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Center, Cochrane Central Register of Controlled Trials, Web of Science from January 1990-November 28, 2022. We included RCTs and observational studies with prospectively-collected data assessing type of protein in patients with non-dialysis CKD. The primary outcome was progression to kidney failure. Secondary outcomes included change in eGFR, albuminuria, all-cause mortality, quality of life.Two authors independently screened titles/abstracts, reviewed full text articles, and extracted data. Meta-analysis was not possible due to variability in outcome reporting and sparse data. Risk of bias was assessed using the Nutrition Quality Evaluation Strengthening Tools.
Results
Eight studies assessing type of protein or dietary patterns emphasizing plant-based food were included. There were 3 RCTs (N=179 patients), which assessed soy protein (2 studies) and Mediterranean diet (1 study) vs. control diets. There were 5 cohort studies (N=4221) assessing plant-based protein intake (3 studies), Mediterranean diet score (1 study), and DASH diet score (1 study). While RCTs demonstrated inconsistency in eGFR outcome, cohort studies demonstrated that higher plant-based protein intake and higher DASH/Mediterranean diet scores were associated with lower risks of end-stage kidney disease and mortality (Figure). Risk of bias was high in RCTs due to selection bias.
Conclusion
Our systematic review of type of protein on CKD progression demonstrated reduced risk of CKD progression in cohort studies, but RCT evidence was limited.