Tags

Type your tag names separated by a space and hit enter

Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials.
Eur J Clin Nutr. 2015 Jul; 69(7):761-8.EJ

Abstract

BACKGROUND/OBJECTIVES

Chronic kidney disease (CKD) is a major health concern associated with increased risk of cardiovascular disease, morbidity and mortality. Current CKD practice guidelines overlook dietary fiber, which is chronically low in the renal diet. However, increasing dietary fiber has been proposed to ameliorate the progress of CKD. We therefore conducted a systematic review and meta-analysis on the effect of dietary fiber intake on serum urea and creatinine as classical markers of renal health in individuals with CKD.

SUBJECTS/METHODS

We searched MEDLINE, EMBASE, CINHAL and the Cochrane Library for relevant clinical trials with a follow-up ⩾7 days. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean difference (MD) with 95% confidence intervals (95% CIs). Heterogeneity was assessed by the Cochran Q statistic and quantified by I(2).

RESULTS

A total of 14 trials involving 143 participants met the eligibility criteria. Dietary fiber supplementation significantly reduced serum urea and creatinine levels in the primary pooled analyses (MD, -1.76 mmol/l (95% CI, -3.00, -0.51), P<0.01 and MD, -22.83 mmol/l (95% CI, -42.63, -3.02), P=0.02, respectively) with significant evidence of interstudy heterogeneity only in the analysis of serum urea.

CONCLUSIONS

This is the first study to summarize the potential beneficial effects of dietary fiber in the CKD population demonstrating a reduction in serum urea and creatinine, as well as highlighting the lack of clinical trials on harder end points. Larger, longer, higher-quality clinical trials measuring a greater variety of uremic toxins in CKD are required (NCT01844882).

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Chiavaroli L
1] Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada [2] Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Mirrahimi A
1] Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada [2] School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
Sievenpiper JL
1] Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada [2] Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada [3] Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada [4] Division of Endocrinology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Jenkins DJ
1] Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada [2] Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada [3] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada [4] Division of Endocrinology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Darling PB
1] Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada [2] Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada [3] Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.

MeSH

BiomarkersCombined Modality TherapyControlled Clinical Trials as TopicCreatinineCross-Over StudiesDietary FiberDietary SupplementsDisease ProgressionFermentationGastrointestinal MicrobiomeHumansPractice Guidelines as TopicRenal DialysisRenal Insufficiency, ChronicUrea

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25387901

Clinical Trial Links

Clinical trial which this article describes

Citation

Chiavaroli, L, et al. "Dietary Fiber Effects in Chronic Kidney Disease: a Systematic Review and Meta-analysis of Controlled Feeding Trials." European Journal of Clinical Nutrition, vol. 69, no. 7, 2015, pp. 761-8.
Chiavaroli L, Mirrahimi A, Sievenpiper JL, et al. Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr. 2015;69(7):761-8.
Chiavaroli, L., Mirrahimi, A., Sievenpiper, J. L., Jenkins, D. J., & Darling, P. B. (2015). Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials. European Journal of Clinical Nutrition, 69(7), 761-8. https://doi.org/10.1038/ejcn.2014.237
Chiavaroli L, et al. Dietary Fiber Effects in Chronic Kidney Disease: a Systematic Review and Meta-analysis of Controlled Feeding Trials. Eur J Clin Nutr. 2015;69(7):761-8. PubMed PMID: 25387901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials. AU - Chiavaroli,L, AU - Mirrahimi,A, AU - Sievenpiper,J L, AU - Jenkins,D J A, AU - Darling,P B, Y1 - 2014/11/12/ PY - 2014/06/25/received PY - 2014/09/11/revised PY - 2014/09/21/accepted PY - 2014/11/13/entrez PY - 2014/11/13/pubmed PY - 2016/3/31/medline SP - 761 EP - 8 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 69 IS - 7 N2 - BACKGROUND/OBJECTIVES: Chronic kidney disease (CKD) is a major health concern associated with increased risk of cardiovascular disease, morbidity and mortality. Current CKD practice guidelines overlook dietary fiber, which is chronically low in the renal diet. However, increasing dietary fiber has been proposed to ameliorate the progress of CKD. We therefore conducted a systematic review and meta-analysis on the effect of dietary fiber intake on serum urea and creatinine as classical markers of renal health in individuals with CKD. SUBJECTS/METHODS: We searched MEDLINE, EMBASE, CINHAL and the Cochrane Library for relevant clinical trials with a follow-up ⩾7 days. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean difference (MD) with 95% confidence intervals (95% CIs). Heterogeneity was assessed by the Cochran Q statistic and quantified by I(2). RESULTS: A total of 14 trials involving 143 participants met the eligibility criteria. Dietary fiber supplementation significantly reduced serum urea and creatinine levels in the primary pooled analyses (MD, -1.76 mmol/l (95% CI, -3.00, -0.51), P<0.01 and MD, -22.83 mmol/l (95% CI, -42.63, -3.02), P=0.02, respectively) with significant evidence of interstudy heterogeneity only in the analysis of serum urea. CONCLUSIONS: This is the first study to summarize the potential beneficial effects of dietary fiber in the CKD population demonstrating a reduction in serum urea and creatinine, as well as highlighting the lack of clinical trials on harder end points. Larger, longer, higher-quality clinical trials measuring a greater variety of uremic toxins in CKD are required (NCT01844882). SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/25387901/full_citation DB - PRIME DP - Unbound Medicine ER -