Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials

Journal of Cachexia, Sarcopenia and Muscle
Connie M RheeKamyar Kalantar-Zadeh

Abstract

Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. We aimed to systematically review and meta-analyse the controlled clinical trials with adequate participants in each trial, providing rigorous contemporary evidence of the impact of a low-protein diet in the management of uraemia and its complications in patients with CKD. We searched MEDLINE (PubMed) and other sources for controlled trials on CKD to compare clinical management of CKD patients under various levels of dietary protein intake or to compare restricted protein intake with other interventions. Studies with similar patients, interventions, and outcomes were included in the meta-analyses. We identified 16 controlled trials of low-protein diet in CKD that met the stringent qualification criteria including having 30 or more participants. Compared with diets with protein intake of >0.8 g/kg/day, diets with restricted protein intake (<0.8 g/kg/day) were associated with higher serum bicarbonate levels, lower phosphorus levels, lower azotemia, lower rates of progression...Continue Reading

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Citations

Feb 8, 2018·The New England Journal of Medicine·Kamyar Kalantar-Zadeh, Denis Fouque
Jun 7, 2018·Journal of Cachexia, Sarcopenia and Muscle·Nicole EbnerStephan von Haehling
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Nov 20, 2019·Current Opinion in Nephrology and Hypertension·Connie M RheeKamyar Kalantar-Zadeh
Dec 11, 2019·Journal of Cachexia, Sarcopenia and Muscle·Markus S AnkerStephan von Haehling
Mar 7, 2020·International journal for vitamin and nutrition research. Internationale Zeitschrift für Vitamin- und Ernährungsforschung. Journal international de vitaminologie et de nutrition·Sepideh Soltani, Ahmad Jayedi
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