Plant-based diets to manage the risks and complications of chronic kidney disease

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 pla...

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Published in:Nature reviews. Nephrology Vol. 16; no. 9; pp. 525 - 542
Main Authors: Carrero, Juan J, González-Ortiz, Ailema, Avesani, Carla M, Bakker, Stephan J L, Bellizzi, Vincenzo, Chauveau, Philippe, Clase, Catherine M, Cupisti, Adamasco, Espinosa-Cuevas, Angeles, Molina, Pablo, Moreau, Karine, Piccoli, Giorgina B, Post, Adrian, Sezer, Siren, Fouque, Denis
Format: Journal Article
Language:English
Published: England Nature Publishing Group 01.09.2020
Subjects:
Acid-Base Equilibrium
Acidosis
Amino acids
Diet
Diet, Healthy
Diet, Mediterranean
Diet, Vegetarian
Dietary Approaches To Stop Hypertension
Dietary Fats, Unsaturated
Dietary Fiber
Disease prevention
Disease Progression
Fruits
Health care
Hemodialysis
Homeostasis
Humans
Hyperkalemia - etiology
Kidney diseases
Metabolism
Microbiota
Nephrology
Phosphorus
Phosphorus, Dietary
Plant Proteins, Dietary
Plant-based foods
Potassium
Potassium, Dietary - adverse effects
Proteins
Quality
Renal Dialysis
Renal Insufficiency, Chronic - diet therapy
Renal Insufficiency, Chronic - metabolism
Restrictions
Vegetables
Vegetarianism
ISSN:1759-5061, 1759-507X, 1759-507X
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Summary: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.
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ISSN:1759-5061
1759-507X
1759-507X
DOI:10.1038/s41581-020-0297-2