Tags

Type your tag names separated by a space and hit enter

Plant-based diets to manage the risks and complications of chronic kidney disease.
Nat Rev Nephrol. 2020 09; 16(9):525-542.NR

Abstract

Traditional dietary recommendations for patients with chronic kidney disease (CKD) focus on the quantity of nutrients consumed. Without appropriate dietary counselling, these restrictions can result in a low intake of fruits and vegetables and a lack of diversity in the diet. Plant nutrients and plant-based diets could have beneficial effects in patients with CKD: increased fibre intake shifts the gut microbiota towards reduced production of uraemic toxins; plant fats, particularly olive oil, have anti-atherogenic effects; plant anions might mitigate metabolic acidosis and slow CKD progression; and as plant phosphorus has a lower bioavailability than animal phosphorus, plant-based diets might enable better control of hyperphosphataemia. Current evidence suggests that promoting the adoption of plant-based diets has few risks but potential benefits for the primary prevention of CKD, as well as for delaying progression in patients with CKD G3-5. These diets might also help to manage and prevent some of the symptoms and metabolic complications of CKD. We suggest that restriction of plant foods as a strategy to prevent hyperkalaemia or undernutrition should be individualized to avoid depriving patients with CKD of these potential beneficial effects of plant-based diets. However, research is needed to address knowledge gaps, particularly regarding the relevance and extent of diet-induced hyperkalaemia in patients undergoing dialysis.

Authors+Show Affiliations

Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. juan.jesus.carrero@ki.se.Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador, Zubirán, Mexico.Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.Nephrology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France.Departments of Medicine and Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador, Zubirán, Mexico.Department of Nephrology, Hospital Universitari Dr Peset, Universitat de València, València, Spain.Renal transplant unit, Pellegrin Hospital, Bordeaux, France.Department of Clinical and Biological Sciences, University of Torino, Torino, Italy. Nephrologie, Centre Hospitalier Le Mans, Le Mans, France.Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.Department of Nephrology, Baskent University School of Medicine, Ankara, Turkey.Department of Nephrology, Université de Lyon, Carmen, Hospital Lyon-Sud, Lyon, France.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32528189

Citation

Carrero, Juan J., et al. "Plant-based Diets to Manage the Risks and Complications of Chronic Kidney Disease." Nature Reviews. Nephrology, vol. 16, no. 9, 2020, pp. 525-542.
Carrero JJ, González-Ortiz A, Avesani CM, et al. Plant-based diets to manage the risks and complications of chronic kidney disease. Nat Rev Nephrol. 2020;16(9):525-542.
Carrero, J. J., González-Ortiz, A., Avesani, C. M., Bakker, S. J. L., Bellizzi, V., Chauveau, P., Clase, C. M., Cupisti, A., Espinosa-Cuevas, A., Molina, P., Moreau, K., Piccoli, G. B., Post, A., Sezer, S., & Fouque, D. (2020). Plant-based diets to manage the risks and complications of chronic kidney disease. Nature Reviews. Nephrology, 16(9), 525-542. https://doi.org/10.1038/s41581-020-0297-2
Carrero JJ, et al. Plant-based Diets to Manage the Risks and Complications of Chronic Kidney Disease. Nat Rev Nephrol. 2020;16(9):525-542. PubMed PMID: 32528189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plant-based diets to manage the risks and complications of chronic kidney disease. AU - Carrero,Juan J, AU - González-Ortiz,Ailema, AU - Avesani,Carla M, AU - Bakker,Stephan J L, AU - Bellizzi,Vincenzo, AU - Chauveau,Philippe, AU - Clase,Catherine M, AU - Cupisti,Adamasco, AU - Espinosa-Cuevas,Angeles, AU - Molina,Pablo, AU - Moreau,Karine, AU - Piccoli,Giorgina B, AU - Post,Adrian, AU - Sezer,Siren, AU - Fouque,Denis, Y1 - 2020/06/11/ PY - 2020/04/23/accepted PY - 2020/6/13/pubmed PY - 2020/11/11/medline PY - 2020/6/13/entrez SP - 525 EP - 542 JF - Nature reviews. Nephrology JO - Nat Rev Nephrol VL - 16 IS - 9 N2 - Traditional dietary recommendations for patients with chronic kidney disease (CKD) focus on the quantity of nutrients consumed. Without appropriate dietary counselling, these restrictions can result in a low intake of fruits and vegetables and a lack of diversity in the diet. Plant nutrients and plant-based diets could have beneficial effects in patients with CKD: increased fibre intake shifts the gut microbiota towards reduced production of uraemic toxins; plant fats, particularly olive oil, have anti-atherogenic effects; plant anions might mitigate metabolic acidosis and slow CKD progression; and as plant phosphorus has a lower bioavailability than animal phosphorus, plant-based diets might enable better control of hyperphosphataemia. Current evidence suggests that promoting the adoption of plant-based diets has few risks but potential benefits for the primary prevention of CKD, as well as for delaying progression in patients with CKD G3-5. These diets might also help to manage and prevent some of the symptoms and metabolic complications of CKD. We suggest that restriction of plant foods as a strategy to prevent hyperkalaemia or undernutrition should be individualized to avoid depriving patients with CKD of these potential beneficial effects of plant-based diets. However, research is needed to address knowledge gaps, particularly regarding the relevance and extent of diet-induced hyperkalaemia in patients undergoing dialysis. SN - 1759-507X UR - https://www.unboundmedicine.com/medline/citation/32528189/Plant_based_diets_to_manage_the_risks_and_complications_of_chronic_kidney_disease_ L2 - https://doi.org/10.1038/s41581-020-0297-2 DB - PRIME DP - Unbound Medicine ER -