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Effects of soy protein containing isoflavones in patients with chronic kidney disease: A systematic review and meta-analysis.
Clin Nutr. 2016 Feb; 35(1):117-124.CN

Abstract

BACKGROUND & AIMS

Recent studies have demonstrated mixed results on the effects of soy intake in patients with CKD, and this have not been systematically analyzed. We conducted this meta-analysis to identify and evaluate the effects of soy protein intake in patients with CKD.

METHODS

A comprehensive search of Medline, Embase and the Cochrane Database of Systematic Reviews was performed in December 2013 and updated in April 2014 for any new trials. Randomized trials designed to evaluate the effects of dietary soy in patients with CKD were collected. Weighted mean effect sizes were calculated for net changes using random-effect or fixed-effect model. All statistical analysis were calculated by RevMan software 5.2 available free from the Cochrane Collaboration.

RESULTS

12 studies (280 participants) were included. And we found that dietary soy was associated with significant decrease of serum creatinine, serum phosphorus, CRP (C reactive protein)and proteinuria in the predialysis subgroup. The mean difference was -0.05 mg/dL (95% CI: -0.10, -0.00 mg/dL; P = 0.04) for serum creatinine, -0.13 mg/dL (95% CI: -0.26, -0.01 mg/dL; P = 0.04) for serum phosphorus, -0.98 mg/L (95% CI: -1.25, -0.71 mg/L; P < 0.00001) for CRP, and -0.13 mg/d (95% CI: -0.18, -0.08 mg/d; P < 0.00001) for proteinuria. We did not find any significant change in serum phosphorus, CRP in the dialysis subgroup. Blood urea nitrogen (BUN) was reduced with statistical significance in the soy-treated group compared with control when the predialysis and dialysis subgroup were analyzed as a whole. The pooled estimated effects of change for BUN was -0.37 mg/dL (95% CI: -6.03, -0.11 mg/dL; P = 0.04). No significant change was detected in creatinine clearance, glomerular filtration rate, serum albumin, body weight and body mass index(BMI).

CONCLUSIONS

Soy protein containing isoflavones intake significantly decreased serum creatinine, serum phosphorus, CRP and proteinura in predialysis patients, while no significant change was found in creatinine clearance and glomerular filtration rate. We also found that soy protein intake could maintain the nutritional status in dialysis patients, though no significant change in CRP, BUN, and serum phosphorus was detected. Future large, long-term RCTs are still needed to clarify the effects of soy protein intake in patients with CKD.

Authors+Show Affiliations

Department of Nephrology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. Electronic address: zhou_jing_2010@126.com.Department of Nephrology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. Electronic address: ywj4169@163.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25882339

Citation

Jing, Zhou, and Yuan Wei-Jie. "Effects of Soy Protein Containing Isoflavones in Patients With Chronic Kidney Disease: a Systematic Review and Meta-analysis." Clinical Nutrition (Edinburgh, Scotland), vol. 35, no. 1, 2016, pp. 117-124.
Jing Z, Wei-Jie Y. Effects of soy protein containing isoflavones in patients with chronic kidney disease: A systematic review and meta-analysis. Clin Nutr. 2016;35(1):117-124.
Jing, Z., & Wei-Jie, Y. (2016). Effects of soy protein containing isoflavones in patients with chronic kidney disease: A systematic review and meta-analysis. Clinical Nutrition (Edinburgh, Scotland), 35(1), 117-124. https://doi.org/10.1016/j.clnu.2015.03.012
Jing Z, Wei-Jie Y. Effects of Soy Protein Containing Isoflavones in Patients With Chronic Kidney Disease: a Systematic Review and Meta-analysis. Clin Nutr. 2016;35(1):117-124. PubMed PMID: 25882339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of soy protein containing isoflavones in patients with chronic kidney disease: A systematic review and meta-analysis. AU - Jing,Zhou, AU - Wei-Jie,Yuan, Y1 - 2015/04/01/ PY - 2014/05/29/received PY - 2015/01/30/revised PY - 2015/03/22/accepted PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/12/15/medline KW - Chronic kidney disease KW - Meta-analysis KW - Randomized controlled trials KW - Soy protein SP - 117 EP - 124 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 35 IS - 1 N2 - BACKGROUND & AIMS: Recent studies have demonstrated mixed results on the effects of soy intake in patients with CKD, and this have not been systematically analyzed. We conducted this meta-analysis to identify and evaluate the effects of soy protein intake in patients with CKD. METHODS: A comprehensive search of Medline, Embase and the Cochrane Database of Systematic Reviews was performed in December 2013 and updated in April 2014 for any new trials. Randomized trials designed to evaluate the effects of dietary soy in patients with CKD were collected. Weighted mean effect sizes were calculated for net changes using random-effect or fixed-effect model. All statistical analysis were calculated by RevMan software 5.2 available free from the Cochrane Collaboration. RESULTS: 12 studies (280 participants) were included. And we found that dietary soy was associated with significant decrease of serum creatinine, serum phosphorus, CRP (C reactive protein)and proteinuria in the predialysis subgroup. The mean difference was -0.05 mg/dL (95% CI: -0.10, -0.00 mg/dL; P = 0.04) for serum creatinine, -0.13 mg/dL (95% CI: -0.26, -0.01 mg/dL; P = 0.04) for serum phosphorus, -0.98 mg/L (95% CI: -1.25, -0.71 mg/L; P < 0.00001) for CRP, and -0.13 mg/d (95% CI: -0.18, -0.08 mg/d; P < 0.00001) for proteinuria. We did not find any significant change in serum phosphorus, CRP in the dialysis subgroup. Blood urea nitrogen (BUN) was reduced with statistical significance in the soy-treated group compared with control when the predialysis and dialysis subgroup were analyzed as a whole. The pooled estimated effects of change for BUN was -0.37 mg/dL (95% CI: -6.03, -0.11 mg/dL; P = 0.04). No significant change was detected in creatinine clearance, glomerular filtration rate, serum albumin, body weight and body mass index(BMI). CONCLUSIONS: Soy protein containing isoflavones intake significantly decreased serum creatinine, serum phosphorus, CRP and proteinura in predialysis patients, while no significant change was found in creatinine clearance and glomerular filtration rate. We also found that soy protein intake could maintain the nutritional status in dialysis patients, though no significant change in CRP, BUN, and serum phosphorus was detected. Future large, long-term RCTs are still needed to clarify the effects of soy protein intake in patients with CKD. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/25882339/Effects_of_soy_protein_containing_isoflavones_in_patients_with_chronic_kidney_disease:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(15)00087-4 DB - PRIME DP - Unbound Medicine ER -