The Role for Protein Restriction in Addition to Renin-Angiotensin-Aldosterone System Inhibitors in the Management of CKD

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Laetitia Koppe, Denis Fouque

Abstract

In experimental studies a low-protein diet (LPD) and renin-angiotensin-aldosterone system (RAAS) inhibitors are both reported to slow the progression of chronic kidney disease (CKD) and reduce proteinuria. RAAS activity contributes to increased blood pressure, fluid retention, and positive sodium balance, but also to kidney damage by enhancing glomerular capillary filtration pressure and synthesis of profibrotic molecules such as transforming growth factor β. It has been well established that an LPD decreases glomerular hyperfiltration and the generation of uremic toxins, as well as the burden of acid load, phosphorus, and sodium. In different animal CKD models, a significant reduction in proteinuria and glomerulosclerosis has been achieved when an RAAS inhibitor and LPD were combined. To date, high-quality intervention trials investigating this combined strategy are lacking. We summarize the experimental and clinical studies that have examined a potential additive action of these therapies on CKD progression. We outline potential mechanisms of action and additive efficacy of an LPD and RAAS inhibitors in CKD, with a particular emphasis on phosphate levels, uremic toxin production, acid load, and salt intake. Finally, although ...Continue Reading

Citations

Jan 16, 2020·Revista da Associação Médica Brasileira·Raíssa Antunes PereiraLilian Cuppari
Feb 14, 2020·Journal of Renal Care·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Feb 16, 2020·Nephrology·Philip K-T LiUNKNOWN World Kidney Day Steering Committee
Mar 7, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Mar 14, 2020·American Journal of Hypertension·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Jul 3, 2020·Nutrients·Kamyar Kalantar-ZadehCsaba P Kovesdy
May 30, 2019·Journal of Clinical Medicine·Lucia Di MiccoBiagio R Di Iorio
Feb 11, 2020·Internal Medicine Journal·Philip K-T LiUNKNOWN World Kidney Day Steering Committee
May 13, 2020·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Philip Kam-Tao LiUNKNOWN World Kidney Day, Steering Committee
Apr 10, 2020·Indian Journal of Nephrology·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Apr 2, 2020·Journal of Nephrology·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Mar 28, 2020·Canadian Journal of Kidney Health and Disease·Philip Kam-Tao LiKamyar Kalantar-Zadeh
Jun 27, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Philip Kam-Tao LiUNKNOWN World Kidney Day Steering Committee
Mar 12, 2020·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·P Kam-Tao LiUNKNOWN World Kidney Day 2020 Steering Committee
Jan 11, 2020·Frontiers in Physiology·Samyuktha Muralidharan PillaiFrançois Verrey
Sep 3, 2020·The Korean Journal of Internal Medicine·Sun Moon Kim, Ji Yong Jung
Dec 22, 2020·The Journal of Experimental Medicine·Shuai HuZhihong Liu
Jan 12, 2021·Frontiers in Medicine·Adamasco CupistiGiorgina B Piccoli
Nov 6, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Qiuling LiWenjian Wang
Dec 22, 2020·Terapevticheskiĭ arkhiv·P Kam-Tao LiK Kalantar-Zadeh
Dec 17, 2020·Current Opinion in Clinical Nutrition and Metabolic Care·Yoko NarasakiKamyar Kalantar-Zadeh
Jun 28, 2021·Lancet·Kamyar Kalantar-ZadehVlado Perkovic
Jun 22, 2021·The Korean Journal of Internal Medicine·Gang-Jee Ko, Kamyar Kalantar-Zadeh
Jun 12, 2020·Kidney Diseases·Philip Kam-Tao LiKamyar Kalantar-Zadeh
Nov 10, 2021·Current Opinion in Nephrology and Hypertension·Kamyar Kalantar-ZadehHolly M Kramer
Jun 17, 2020·Current Hypertension Reviews·Rodolfo Valtuille

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