No CrossRef data available.
Article contents
Protein consumption and personalised nutrition in CKD: a comprehensive review
Published online by Cambridge University Press: 17 February 2025
Abstract
Chronic kidney disease (CKD) poses a global health challenge, with dietary protein intake being a key factor in disease management. This review synthesises evidence on the impact of different protein intake strategies, including low-protein diet (LPD), very-low-protein diet (VLPD), high-protein diet (HPD) and plant-based diet (PBD), on CKD progression and patient outcomes. The review explores personalised nutrition strategies and identifies gaps in the literature. A systematic search of PubMed, Cochrane Library, Web of Science and Scopus was conducted, covering studies published from 1982 to 2024, including randomised controlled trials (RCT), observational studies and meta-analyses involving adult patients with CKD. The findings suggest that LPD and VLPD may slow CKD progression, particularly when supplemented with ketoanalogues, but adherence and long-term benefits remain uncertain. PBD are associated with reduced renal burden and improved metabolic health, although achieving adequate protein intake from plant sources requires careful planning. HPD, particularly those rich in animal protein, may exacerbate CKD progression, although recent research indicates that higher protein intake may benefit specific populations, such as older adults with mild-to-moderate CKD. In conclusion, managing protein intake in CKD is complex and necessitates a personalised approach. While LPD and PBD offer potential benefits, their long-term success is contingent upon patient adherence, individualised dietary management and further research into their sustained effects. Future research should focus on long-term RCT and the development of personalised nutrition strategies incorporating emerging technologies and multidisciplinary care to optimise CKD management.
Keywords
- Type
- Review Article
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society
References
Kovesdy, CP (2022) Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl 12, 7–11; Elsevier B.V.Google Scholar
Alvirdizadeh, S, Yuzbashian, E, Mirmiran, P, Eghtesadi, S, & Azizi, F (2020) A prospective study on total protein, plant protein and animal protein in relation to the risk of incident chronic kidney disease. BMC Nephrol 21, 1–7.Google Scholar
Bernier-Jean, A, Prince, RL, Lewis, JR, Craig, JC, Hodgson, JM, Lim, WH, et al. (2021) Dietary plant and animal protein intake and decline in estimated glomerular filtration rate among elderly women: a 10-year longitudinal cohort study. Nephrol Dial Transplant 36, 1640–1647.Google Scholar
Gutiérrez, OM, Muntner, P, Rizk, D V., McClellan, WM, Warnock, DG, Newby, PK, et al. (2014) Dietary patterns and risk of death and progression to ESRD in individuals with CKD: a cohort study. Am J Kidney Dis 64, 204–213.Google Scholar
Piccoli, GB, Cederholm, T, Avesani, CM, Bakker, SJL, Bellizzi, V, Cuerda, C, et al. (2023) Nutritional status and the risk of malnutrition in older adults with chronic kidney disease – implications for low protein intake and nutritional care: a critical review endorsed by ERN-ERA and ESPEN. Clin Nutr 42, 443–457; Churchill Livingstone.Google Scholar
Hansen, HP, Tauber-Lassen, E, Jensen, BR, & Parving, HH (2002) Effect of dietary protein restriction on prognosis in patients with diabetic nephropathy. Kidney Int 62, 220–228.Google Scholar
Fouque, D & Laville, M (2009) Low protein diets for chronic kidney disease in non diabetic adults. Cochrane Database Syst Rev (3), CD001892. doi: 10.1002/14651858.CD001892.pub3 (Update in: Cochrane Database Syst Rev. 2018 Oct 04, 10, CD001892. doi: 10.1002/14651858.CD001892.pub4).Google Scholar
Haring, B, Selvin, E, Liang, M, Coresh, J, Grams, ME, Petruski-Ivleva, N, et al. (2017) Dietary protein sources and risk for incident chronic kidney disease: results from the Atherosclerosis Risk in Communities (ARIC) study. J Renal Nutr 27, 233–242.Google Scholar
Chen, X, Wei, G, Jalili, T, Metos, J, Giri, A, Cho, ME, et al. (2016) The associations of plant protein intake with all-cause mortality in CKD. Am J Kidney Dis 67, 423–430.Google Scholar
Aparicio, M, Chauveau, P, Vaĺ, V, De Précigout, V, Précigout, P, Bouchet, JL, et al. (2000) Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet [Internet]. Available from: http://journals.lww.com/jasn
Google Scholar
Evanoff, GV, Thompson, CS, Brown, J, & Weinman, EJ (1987) The effect of dietary protein restriction on the progression of diabetic nephropathy: a 12-month follow-up. Arch Intern Med [Internet]. 1987 Mar 1 [cited 2024 Jul 31];147, 492–495. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/607958
Google Scholar
Cianciaruso, B, Pota, A, Pisani, A, Torraca, S, Annecchini, R, Lombardi, P, et al. (2008) Metabolic effects of two low protein diets in chronic kidney disease stage 4–5 – a randomized controlled trial. Nephrol Dial Transplant 23, 636–644.Google Scholar
Anderson, CE, Gilbert, RD, & Elia, M (2015) Basal metabolic rate in children with chronic kidney disease and healthy control children. Pediatr Nephrol 30, 1995–2001.Google Scholar
Duarte, MP, Almeida, LS, Neri, SGR, Oliveira, JS, Wilkinson, TJ, Ribeiro, HS, et al. (2024) Prevalence of sarcopenia in patients with chronic kidney disease: a global systematic review and meta-analysis. J Cachexia Sarcopenia Muscle [Internet]. 2024 Apr 1 [cited 2024 Aug 16];15, 501–512. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jcsm.13425
Google Scholar
Massini, G, Caldiroli, L, Molinari, P, Maria, F, Carminati, I, Castellano, G, et al. (2023) Nutritional strategies to prevent muscle loss and sarcopenia in chronic kidney disease: what do we currently know? Nutrients 2023 [Internet]. 2023 [cited 2024 Aug 16]. Available from: https://www.mdpi.com/2072-6643/15/14/3107
Google Scholar
Maschio, G, Oldrizzi, L, Tessitore, N, D’Angelo, A, Valvo, E, Lupo, A, et al. (1982) Effects of dietary protein and phosphorus restriction on the progression of early renal failure. Kidney Int 22, 371–376.Google Scholar
Ihle, BU, Becker, GJ, Whitworth, JA, Charlwood, RA, Kincaid-Smith, PS (1989) The effect of protein restriction on the progression of renal insufficiency. N Engl J Med [Internet]. 1989 Dec 28 [cited 2024 Jul 30];321, 1773–1777. Available from: https://www.nejm.org/doi/abs/10.1056/NEJM198912283212601
Google Scholar
Garneata, L, Stancu, A, Dragomir, D, Stefan, G, & Mircescu, G (2016) Ketoanalogue-supplemented vegetarian very low–protein diet and CKD progression. J Am Soc Nephrol 27, 2164–2176.Google Scholar
Li, Q, Wen, F, Wang, Y, Li, S, Lin, S, Qi, C, et al. (2021) Diabetic kidney disease benefits from intensive low-protein diet: updated systematic review and meta-analysis. Diabetes Ther [Internet]. 2021 Jan 1 [cited 2024 Aug 1];12, 21–36. Available from: https://link.springer.com/article/10.1007/s13300-020-00952-5
Google Scholar
Chewcharat, A, Takkavatakarn, K, Wongrattanagorn, S, Panrong, K, Kittiskulnam, P, Eiam-Ong, S, et al. (2020) The effects of restricted protein diet supplemented with Ketoanalogue on renal function, blood pressure, nutritional status, and chronic kidney disease-mineral and bone disorder in chronic kidney disease patients: a systematic review and meta-analysis. J Renal Nutr [Internet]. 2020 May 1 [cited 2024 Aug 1];30, 189–199. Available from: http://www.jrnjournal.org/article/S1051227619302912/fulltext
Google Scholar
Mitch, WE, Walser, M, Steinman, TI, Hill, S, Zeger, S, Tungsanga, K (1984) The effect of a Keto acid–amino acid supplement to a restricted diet on the progression of chronic renal failure. N Engl J Med [Internet]. 1984 Sep 6 [cited 2024 Jul 30];311, 623–629. Available from: https://www.nejm.org/doi/full/10.1056/nejm198409063111002
Google Scholar
Ciavarella, A, Di Mizio, G, Stefoni, S, Borgnino, LC, & Vannini, P (1987) Reduced albuminuria after dietary protein restriction in insulin-dependent diabetic patients with clinical nephropathy. Diabetes Care [Internet]. 1987 Jul 1 [cited 2024 Aug 2];10, 407–413. https://doi.org/10.2337/diacare.10.4.407
Google Scholar
Brouhard, BH & Lagrone, L (1990) Effect of dietary protein restriction on functional renal reserve in diabetic nephropathy. Am J Med 89, 427–431.Google Scholar
Zeller, K, Whittaker, E, Sullivan, L, Raskin, P, & Jacobson, HR (1991) Effect of restricting dietary protein on the progression of renal failure in patients with insulin-dependent diabetes mellitus. N Engl J Med 324, 78–84.Google Scholar
Dullaart, RPF, Beusekamp, BJ, Meijer, S, Van Doormaal, JJ, & Sluiter, WJ (1993) Long-term effects of protein-restricted diet on albuminuria and renal function in IDDM patients without clinical nephropathy and hypertension. Diabetes Care [Internet]. 1993 Feb 1 [cited 2024 Jul 30];16, 483–492. https://doi.org/10.2337/diacare.16.2.483
Google Scholar
D’Amico, G, Gentile, MG, Fellin, G, Manna, G, & Cofano, F (1994) Effect of dietary protein restriction on the progression of renal failure: a prospective randomized trial. Nephrol Dial Transplant [Internet]. 1994 Jan 1 [cited 2024 Aug 2];9, 1590–1594. https://doi.org/10.1093/ndt/9.11.1590
Google Scholar
Raal, FJ, Kalk, WJ, Lawson, M, Esser, JD, Buys, R, Fourie, L, et al. (1994) Effect of moderate dietary protein restriction on the progression of overt diabetic nephropathy: a 6-mo prospective study. Am J Clin Nutr 60, 579–585.Google Scholar
Levey, AS, Greene, T, Beck, GJ, Caggiula, AW, Kusek, JW, Hunsicker, LG, et al. (1999) Dietary protein restriction and the progression of chronic renal disease: what have all of the results of the MDRD study shown? [Internet]. Available from: http://journals.lww.com/jasn
Google Scholar
Di Iorio, BR, Minutolo, R, De Nicola, L, Bellizzi, V, Catapano, F, Iodice, C, et al. (2003) Supplemented very low protein diet ameliorates responsiveness to erythropoietin in chronic renal failure. Kidney Int 64, 1822–1828.Google Scholar
Meloni, C, Tatangelo, P, Cipriani, S, Rossi, V, Suraci, C, Tozzo, C, et al. (2004) Adequate protein dietary restriction in diabetic and nondiabetic patients with chronic renal failure. J Renal Nutr 14, 208–213.Google Scholar
Feiten, SF, Draibe, SA, Watanabe, R, Duenhas, MR, Baxmann, AC, Nerbass, FB, et al. (2005) Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients. Eur J Clin Nutr 2005 59:1 [Internet]. 2004 Sep 8 [cited 2024 Aug 2];59, 129–136. Available from: https://www.nature.com/articles/1602050
Google Scholar
Prakash, S, Pande, DP, Sharma, S, Sharma, D, Bal, CS, & Kulkarni, H (2004) Randomized, double-blind, placebo-controlled trial to evaluate efficacy of ketodiet in predialytic chronic renal failure. J Renal Nutr 14, 89–96.Google Scholar
Brunori, G, Viola, BF, Parrinello, G, De Biase, V, Como, G, Franco, V, et al. (2007) Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis 49, 569–580.Google Scholar
Mircescu, G, Gârneaţǎ, L, Stancu, SH, & Cǎpuşǎ, C (2007) Effects of a supplemented hypoproteic diet in chronic kidney disease. J Renal Nutr 17, 179–188.Google Scholar
Teplan, V, Schück, O, Racek, J, Mareckova, O, Stollova, M, Hanzal, V, et al. (2008) Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial. Wien Klin Wochenschr [Internet]. 2008 Aug [cited 2024 Aug 2];120, 478–485. Available from: https://link.springer.com/article/10.1007/s00508-008-0987-4
Google Scholar
Moe, SM, Zidehsarai, MP, Chambers, MA, Jackman, LA, Radcliffe, JS, Trevino, LL, et al. (2011) Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol 6, 257–264.Google Scholar
Qiu, HY, Liu, F, Zhao, LJ, Huang, SM, Zuo, C, Zhong, H, et al. (2012) Comparison of the effects of alpha-keto/ amino acid supplemented low protein diet and diabetes diet in patients with diabetic nephropathy. Sichuan Da Xue Xue Bao Yi Xue Ban [Internet]. 2012 May 1 [cited 2024 Aug 3];43, 425–428. Available from: https://europepmc.org/article/med/22812251
Google Scholar
Mou, S, Li, J, Yu, Z, Wang, Q, & Ni, Z (2013) Keto acid-supplemented low-protein diet for treatment of adult patients with hepatitis B virus infection and chronic glomerulonephritis. [Internet]. 2013 Jan 24 [cited 2024 Aug 2];41, 129–137. Available from: https://journals.sagepub.com/doi/full/10.1177/0300060512474758
Google Scholar
Giordano, M, Ciarambino, T, Castellino, P, Cataliotti, A, Malatino, L, Ferrara, N, et al. (2014) Long-term effects of moderate protein diet on renal function and low-grade inflammation in older adults with type 2 diabetes and chronic kidney disease. Nutrition 30, 1045–1049.Google Scholar
di Iorio, BR, di Micco, L, Marzocco, S, de Simone, E, de Blasio, A, Sirico, ML, et al. (2017) Very low-protein diet (VLPD reduces metabolic acidosis in subjects with chronic kidney disease: the “Nutritional Light Signal” of the renal acid load. Nutrients 9, Page 69 [Internet]. 2017 Jan 17 [cited 2024 Aug 3];9, 69. Available from: https://www.mdpi.com/2072-6643/9/1/69/htm
Google Scholar
Podadera-Herreros, A, Alcala-Diaz, JF, Gutierrez-Mariscal, FM, Jimenez-Torres, J, Cruz-Ares, S de la, Arenas-de Larriva, AP, et al. (2022) Long-term consumption of a mediterranean diet or a low-fat diet on kidney function in coronary heart disease patients: the CORDIOPREV randomized controlled trial. Clin Nutr 41, 552–559.Google Scholar
Friedman, AN (2004) High-protein diets: potential effects on the kidney in renal health and disease. Am J Kidney Dis 44, 950–962.Google Scholar
Kalantar-Zadeh, K, Kramer, HM, & Fouque, D (2020) High-protein diet is bad for kidney health: unleashing the taboo. Nephrol Dial Transplant 35, 1–4. Oxford University Press.Google Scholar
Kubo, S, Imano, H, Muraki, I, Kitamura, A, Noda, H, Cui, R, et al. (2023) Total protein intake and subsequent risk of chronic kidney disease: the circulatory risk in communities study. Environ Health Prev Med 28, 32.Google Scholar
Williams, P, Stevens, M, Fass, G, Irons, L, & Bone, J (1991) Failure of dietary protein and phosphate restriction to retard the rate of progression of chronic renal failure: a prospective, randomized, controlled trial. QJM: Int J Med [Internet]. 1991 Oct 1 [cited 2024 Jul 30];81, 837–855. https://doi.org/10.1093/oxfordjournals.qjmed.a068633
Google Scholar
Klahr, S, Levey, AS, Beck, GJ, Caggiula, AW, Hunsicker, L, Kusek, JW, et al. (1994) The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. N Engl J Med [Internet]. 1994 Mar 31 [cited 2024 Jul 30];330, 877–884. Available from: https://www.nejm.org/doi/full/10.1056/NEJM199403313301301
Google Scholar
Bagros, P, Malvy, D, Maingourd, C, Pengloan, J, Nivet, H (1999) Effects of Severe Protein Restriction with Ketoanalogues in Advanced Renal Failure. J Am Coll Nutr 18, 481–486.Google Scholar
Kopple, JD, Levey, AS, Greene, T, Chumlea, WC, Gassman, JJ, Hollinger, DL, et al. (1997) Effect of dietary protein restriction on nutritional status in the modification of diet in renal disease study. Kidney Int 52, 778–791.Google Scholar
Bernhard, J, Beaufrère, B, Laville, M, & Fouque, D (2001) Adaptive response to a low-protein diet in predialysis chronic renal failure patients. J Am Soc Nephrol [Internet]. 2001 [cited 2024 Aug 2];12, 1249–1254. Available from: https://journals.lww.com/jasn/fulltext/2001/06000/adaptive_response_to_a_low_protein_diet_in.18.aspx
Google Scholar
Pijls, LTJ, de Vries, H, van Eijk, JTM, & Donker, AJM (2002) Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: a randomized trial. Eur J Clin Nutr 56:12 [Internet]. 2002 Dec 20 [cited 2024 Aug 2];56, 1200–1207. Available from: https://www.nature.com/articles/1601474
Google Scholar
Dussol, B, Iovanna, C, Raccah, D, Darmon, P, Morange, S, Vague, P, et al. (2005) A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. J Renal Nutr 15, 398–406.Google Scholar
Levey, AS, Greene, T, Sarnak, MJ, Wang, X, Beck, GJ, Kusek, JW, et al. (2006) Effect of dietary protein restriction on the progression of kidney disease: long-term follow-up of the modification of diet in renal disease (MDRD) study. Am J Kidney Dis 48, 879–888.Google Scholar
Cianciaruso, B, Pota, A, Bellizzi, V, Di, Giuseppe D, Di, Micco L, Minutolo, R, et al. (2009) Effect of a low- versus moderate-protein diet on progression of CKD: follow-up of a randomized controlled trial. YAJKD [Internet];54, 1052–1061. Available from: www.controlled-trials.com
Google Scholar
Koya, D, Haneda, M, Inomata, S, Suzuki, Y, Suzuki, D, Makino, H, et al. (2009) Long-term effect of modification of dietary protein intake on the progression of diabetic nephropathy: a randomised controlled trial. Diabetologia 52, 2037–2045.Google Scholar
Menon, V, Kopple, JD, Wang, X, Beck, GJ, Collins, AJ, Kusek, JW, et al. (2009) Effect of a very low-protein diet on outcomes: long-term follow-up of the modification of diet in renal disease (MDRD) study. Am J Kidney Dis 53, 208–217.Google Scholar
Jesudason, DR, Pedersen, E, & Clifton, PM (2013) Weight-loss diets in people with type 2 diabetes and renal disease: a randomized controlled trial of the effect of different dietary protein amounts. Am J Clin Nutr 98, 494–501.Google Scholar
Bellizzi, V, Signoriello, S, Minutolo, R, Di Iorio, B, Nazzaro, P, Garofalo, C, et al. (2022) No additional benefit of prescribing a very low-protein diet in patients with advanced chronic kidney disease under regular nephrology care: a pragmatic, randomized, controlled trial. Am J Clin Nutr 115, 1404–1417.Google Scholar
Cacciapuoti, N, Lonardo, MS, Di Lauro, M, Di Lorenzo, M, Aurino, L, Pacella, D, et al. (2024) Effects of dietary intervention on nutritional status in elderly individuals with chronic kidney disease. Nutrients 16, 632.Google Scholar
Narasaki, Y, Rhee, CM, Kramer, H, & Kalantar-Zadeh, K (2021) Protein intake and renal function in older patients. Curr Opin Clin Nutr Metab Care 24, 10–17, Lippincott Williams and Wilkins.Google Scholar
Huang, J, Yu, Y, Li, H, Wei, Y, & Sun, M (2023) Effect of dietary protein intake on cognitive function in the elderly with chronic kidney disease: analysis of the National Health and Nutrition Examination Survey 2011–2014. Ren Fail 45, 2294147.Google Scholar
Marrone, G, Urciuoli, S, Di Lauro, M, Cornali, K, Masci, C, Tesauro, M, et al. (2024) The possible role of plant-based bars consumption in CKD geriatric patients. Pharmaceuticals 17, 1689.Google Scholar
Wee Teo, B, Chun Toh, Q, Xu, H, Yang, AY, Lin, T, Li, J, et al. Dietary protein intake in a multi-ethnic Asian population of healthy participants and chronic kidney disease patients [Internet]. Available from: www.eatright.org
Google Scholar
Torreggiani, M, Fois, A, Moio, MR, Chatrenet, A, Mazé, B, Lippi, F, et al. (2021) Spontaneously low protein intake in elderly CKD patients: myth or reality? Analysis of baseline protein intake in a large cohort of patients with advanced CKD. Nutrients 13, 4371.Google Scholar
Villain, C, Wagner, S, & Koppe, L (2023) Elderly patients with chronic kidney disease: towards a better control of protein intake. Nephrol Dial Transplant [Internet]. 2023 Oct 31 [cited 2024 Aug 16];38, 2420–2422. https://doi.org/10.1093/ndt/gfad129
Google Scholar
Meloni, C, Morosetti, M, Suraci, C, Pennafina, MG, Tozzo, C, Taccone-Gallucci, M, et al. (2002) Severe dietary protein restriction in overt diabetic nephropathy: benefits or risks? J Renal Nutr 12, 96–101.Google Scholar
Carballo-Casla, A, Carla, MA, Beridze, G, Ortolá, R, García-Esquinas, E, et al. (2024) Protein intake and mortality in older adults with chronic kidney disease. JAMA Netw Open [Internet]. 2024 Aug 1 [cited 2024 Aug 9];7, e2426577. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822055
Google Scholar
Cai, Q, Duan, MJ, Dekker, LH, Carrero, JJ, Avesani, CM, Bakker, SJL, et al. (2022) Ultraprocessed food consumption and kidney function decline in a population-based cohort in the Netherlands. Am J Clin Nutr 116, 263–273.Google Scholar
D’Alessandro, C, Piccoli, GB, Calella, P, Brunori, G, Pasticci, F, Egidi, MF, et al. (2016) “Dietaly”: Practical issues for the nutritional management of CKD patients in Italy. BMC Nephrol [Internet]. 2016 Jul 29 [cited 2024 Aug 10];17, 1–18. Available from: https://link.springer.com/articles/10.1186/s12882-016-0296-5
Google Scholar
Carrero, JJ, Thomas, F, Nagy, K, Arogundade, F, Avesani, CM, Chan, M, et al. (2018) Global prevalence of protein-energy wasting in kidney disease: a meta-analysis of contemporary observational studies from the International Society of Renal Nutrition and Metabolism. J Renal Nutr 28, 380–392.Google Scholar
Wang, S, Fan, X, Zheng, X, Xia, P, Zou, H, Zhang, Z, et al. (2024) Association between dietary acid load and chronic kidney disease in the chinese population: a comprehensive analysis of the China Health and Nutrition Survey (2009). Nutrients 16, 2461 [Internet]. 2024 Jul 29 [cited 2024 Aug 16];16(15):2461. Available from: https://www.mdpi.com/2072-6643/16/15/2461/htm
Google Scholar
Weimbs, T, Saville, J, & Kalantar-Zadeh, K (2024) Ketogenic metabolic therapy for chronic kidney disease – the pro part. Clin Kidney J [Internet]. 2024 Jan 4 [cited 2024 Aug 16];17, 1–8. https://doi.org/10.1093/ckj/sfad273
Google Scholar
Hu, EA, Steffen, LM, Grams, ME, Crews, DC, Coresh, J, Appel, LJ, et al. (2019) Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Am J Clin Nutr 110, 713–721.Google Scholar
Lew, QLJ, Jafar, TH, Koh, HWL, Jin, A, Chow, KY, Yuan, JM, et al. (2017) Red meat intake and risk of ESRD. J Am Soc Nephrol 28, 304–312.Google Scholar
Heo, GY, Koh, HB, Kim, HJ, Kim, KW, Jung, CY, Kim, HW, et al. (2023) Association of plant protein intake with risk of incident CKD: a UK Biobank study. Am J Kidney Dis 82, 687–697.e1.Google Scholar
Kaysen, GA, Gambertoglio, J, Jimenez, I, Jones, H, & Hutchison, FN (1986) Effect of dietary protein intake on albumin homeostasis in nephrotic patients. Kidney Int 29, 572–577.Google Scholar
Walker, JD, Dodds, RA, Murrells, TJ, Bending, JJ, Mattock, MB, Keen, H, et al. (1989) Restriction of dietary protein and progression of renal failure in diabetic nephropathy. The Lancet 334, 1411–1415.Google Scholar
Kontessis, P, Jones, S, Dodds, R, Trevisan, R, Nosadini, R, Firett, P, et al. (1990) Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins. Kidney Int 38, 136–144.Google Scholar
Toeller, M, Buyken, A, Heitkamp, G, Brä Mswig, S, Mann, J, Milne, R, et al. (1997) Protein intake and urinary albumin excretion rates in the EURODIAB IDDM complications study. Diabetologia 40, 1219–1226.Google Scholar
Knight, EL, Stampfer, MJ, Hankinson, SE, Spiegelman, D, Curhan, GC (2003) The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency Background: In individuals with moderate to severe renal in [Internet]. Available from: www.annals.org
Google Scholar
Gennari, FJ, Hood, VL, Greene, T, Wang, X, Levey, AS (2006) Effect of dietary protein intake on serum total CO2 concentration in chronic kidney disease: Modification of Diet in Renal Disease study findings. Clin J Am Soc Nephrol 1, 52–7.Google Scholar
Chauveau, P, Combe, C, Rigalleau, V, Vendrely, B, Aparicio, M (2007) Restricted protein diet is associated with decrease in proteinuria: consequences on the progression of renal failure. J Renal Nutr 17, 250–7.Google Scholar
Bellizzi, V, Di Iorio, BR, De Nicola, L, Minutolo, R, Zamboli, P, Trucillo, P, et al. (2007) Very low protein diet supplemented with ketoanalogs improves blood pressure control in chronic kidney disease. Kidney Int 71, 245–51.Google Scholar
Nettleton, JA, Steffen, LM, Palmas, W, Burke, GL, Jacobs, DR (2008) Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis 1–3 [Internet]. Am J Clin Nutr 87. Available from: https://academic.oup.com/ajcn/article-abstract/87/6/1825/4633303
Google Scholar
Scialla, JJ, Appel, LJ, Astor, BC, Miller, ER, Beddhu, S, Woodward, M, et al. (2012) Net endogenous acid production is associated with a faster decline in GFR in African Americans. Kidney Int 82, 106–12.Google Scholar
Moore, LW, Byham-Gray, LD, Scott Parrott, J, Rigassio-Radler, D, Mandayam, S, Jones, SL, et al. (2013) The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines. Kidney Int 83, 724–32.Google Scholar
Malhotra, R, Lipworth, L, Cavanaugh, KL, Young, BA, Tucker, KL, Carithers, TC, et al. (2018) Protein intake and long-term change in glomerular filtration rate in the Jackson heart study. J Renal Nutr 28, 245–50.Google Scholar
Di Iorio, BR, Marzocco, S, Bellasi, A, De Simone, E, Dal Piaz, F, Rocchetti, MT, et al. (2018) Nutritional therapy reduces protein carbamylation through urea lowering in chronic kidney disease. Nephrol Dial Transplant [Internet]. 2018 May 1 [cited 2024 Aug 3];33, 804–13. Available from: https://doi.org/10.1093/ndt/gfx203
Google Scholar
Kwon, YJ, Park, K, Lee, JH (2022) Low-protein diet is inversely related to the incidence of chronic kidney disease in middle-aged and older adults: results from a community-based prospective cohort study. Eur J Nutr 61, 3795–807.Google Scholar
Sekiguchi, T, Kabayama, M, Ryuno, H, Tanaka, K, Kiyoshige, E, Akagi, Y, et al. (2022) Association between protein intake and changes in renal function among Japanese community-dwelling older people: the SONIC study. Geriatr Gerontol Int 22, 286–91.Google Scholar
Teymoori, F, Farhadnejad, H, Jahromi, MK, Vafa, M, Ahmadirad, H, Mirmiran, P, et al. (2022) Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: findings from a prospective cohort study. Front Nutr 9, 1003545.Google Scholar
Otani, H, Okada, T, Saika, Y, Sakagashira, M, Oda, H, Ito, Y, et al. (2023) Effect of nonsupplemented low-protein diet on the initiation of renal replacement therapy in stage 4 and 5 chronic kidney disease: a retrospective multicenter cohort study in Japan. J Renal Nutr [Internet]. 2023 Sep 1 [cited 2024 Aug 9];33, 649–656. Available from: http://www.jrnjournal.org/article/S1051227623000742/fulltext
Google Scholar
Shirai, N, Yamamoto, S, Osawa, Y, Tsubaki, A, Morishita, S, Murayama, T, et al. (2024) Protein intake and its relationship with frailty in chronic kidney disease. Clin Exp Nephrol [Internet]. 2024 May 1 [cited 2024 Aug 9];28, 447–453. Available from: https://link.springer.com/article/10.1007/s10157-023-02452-9
Google Scholar
Gonzalez, P, Lozano, P, & Solano, F (2022) Unraveling the metabolic hallmarks for the optimization of protein intake in pre-dialysis chronic kidney disease patients. Nutrients 14, 1182.Google Scholar
Oosterwijk, MM, Navis, G, Bakker, SJL, & Laverman, GD (2022) Personalized nutrition in patients with type 2 diabetes and chronic kidney disease: the two-edged sword of dietary protein intake. J Personal Med 12, 300.Google Scholar
Naber, T & Purohit, S (2021) Chronic kidney disease: role of diet for a reduction in the severity of the disease. Nutrients 13, 3277.Google Scholar
Chapter 3: Delaying CKD progression and managing its complications 3.1 CKD treatment and risk modification [Internet]. Available from: www.kidney-international.org
Google Scholar
Alp Ikizler, T, Burrowes, JD, Byham-Gray, LD, Campbell, KL, Carrero, JJ, Chan, W, et al. (2020) KDOQI clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis 76, S1–S7.Google Scholar
Isaka, Y (2021) Optimal protein intake in pre-dialysis chronic kidney disease patients with sarcopenia: an overview. Nutrients 13, 1205.Google Scholar
Farrington, K, Covic, A, Aucella, F, Clyne, N, De Vos, L, Findlay, A, et al. (2016) Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3B or higher (EGFR <45 mL/min/1.73 m2). Vol. 32, Nephrology Dialysis Transplantation. Oxford University Press, pp. ii1–66.Google Scholar
Fiaccadori, E, Sabatino, A, Barazzoni, R, Carrero, JJ, Cupisti, A, De Waele, E, et al. (2021) ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease. Clin Nutr 40, 1644–1668.Google Scholar
Chronic kidney disease: assessment and management NICE guideline [Internet] (2021) Available from: www.nice.org.uk/guidance/ng203
Google Scholar