Document Detail

Dietary management of chronic kidney disease: protein restriction and beyond.
MedLine Citation:
PMID:  23079747     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: More kidney protective strategies are needed to reduce the burden of complete kidney failure from chronic kidney disease (CKD). Clinicians sometimes use protein restriction as kidney protection despite its demonstrated lack of effectiveness in the only large-scale study. Small-scale studies support that dietary acid reduction is kidney-protective, including when done with base-inducing foods like fruits and vegetables. We review these studies in light of current kidney-protective recommendations.
RECENT FINDINGS: Animal models of CKD show that acid-inducing dietary protein exacerbates and base-inducing protein ameliorates nephropathy progression, and that increased intake of acid-inducing but not base-inducing dietary protein exacerbates progression. Clinical studies show that dietary acid reduction with Na-based alkali reduces kidney injury and slows nephropathy progression in patients with CKD and reduced glomerular filtration rate (GFR); base-inducing fruits and vegetables reduce kidney injury in patients with reduced GFR; and base-inducing fruits and vegetables improve metabolic acidosis in CKD.
SUMMARY: Protein type rather than amount might more importantly affect nephropathy progression. Base-inducing foods might be another way to reduce dietary acid, a strategy shown in small studies to slow nephropathy progression. Further studies will determine if CKD patients should be given base-inducing food as part of their management.
Nimrit Goraya; Donald E Wesson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  21     ISSN:  1473-6543     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2013-03-29     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Texas A&M Health Sciences Center College of Medicine, Temple, Texas 76508, USA.
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MeSH Terms
Acid-Base Equilibrium
Diet, Protein-Restricted*
Dietary Proteins / adverse effects,  metabolism*
Disease Progression
Hydrogen-Ion Concentration
Kidney / metabolism*,  physiopathology
Renal Insufficiency, Chronic / diet therapy*,  metabolism,  physiopathology
Treatment Outcome
Reg. No./Substance:
0/Dietary Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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