by Shivam Joshi, Sanjeev Shah and Kamyar Kalantar-Zadeh
Abstract:
Concerns regarding protein and amino acid deficiencies with plant-based proteins have precluded their use in chronic kidney disease (CKD) patients. Many of these concerns were debunked years ago, but recommendations persist regarding the use of "high-biological value" (animal-based) proteins in CKD patients, which may contribute to worsening of other parameters such as blood pressure, metabolic acidosis, and hyperphosphatemia. Plant-based proteins are sufficient in meeting both quantity and quality requirements. Those eating primarily plant-based diets have been observed to consume approximately 1.0 g/kg/day of protein, or more. CKD patients have been seen to consume 0.7-0.9 g/kg/day of mostly plant-based protein without any negative effects. Furthermore, those substituting animal-based proteins for plant-based proteins have shown reductions in severity of hypertension, hyperphosphatemia, and metabolic acidosis. Plant-based proteins, when consumed in a varied diet, are not only nutritionally adequate but have pleiotropic effects which may favor their use in CKD patients.
Reference:
Adequacy of Plant-Based Proteins in Chronic Kidney Disease. (Shivam Joshi, Sanjeev Shah and Kamyar Kalantar-Zadeh), In J Ren Nutr, volume 29, 2019.
Bibtex Entry:
@article{Joshi:2019aa,
abstract = {Concerns regarding protein and amino acid deficiencies with plant-based proteins have precluded their use in chronic kidney disease (CKD) patients. Many of these concerns were debunked years ago, but recommendations persist regarding the use of "high-biological value" (animal-based) proteins in CKD patients, which may contribute to worsening of other parameters such as blood pressure, metabolic acidosis, and hyperphosphatemia. Plant-based proteins are sufficient in meeting both quantity and quality requirements. Those eating primarily plant-based diets have been observed to consume approximately 1.0 g/kg/day of protein, or more. CKD patients have been seen to consume 0.7-0.9 g/kg/day of mostly plant-based protein without any negative effects. Furthermore, those substituting animal-based proteins for plant-based proteins have shown reductions in severity of hypertension, hyperphosphatemia, and metabolic acidosis. Plant-based proteins, when consumed in a varied diet, are not only nutritionally adequate but have pleiotropic effects which may favor their use in CKD patients.},
address = {Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: afternoonrounds@gmail.com.; Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.; Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Orange, California.},
author = {Joshi, Shivam and Shah, Sanjeev and Kalantar-Zadeh, Kamyar},
copyright = {Copyright {\copyright}2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.},
crdt = {2018/08/21 06:00},
date = {2019 Mar},
date-added = {2023-01-08 14:20:32 +0000},
date-modified = {2023-06-03 19:57:13 +0100},
dcom = {20200618},
dep = {20180816},
doi = {10.1053/j.jrn.2018.06.006},
edat = {2018/08/21 06:00},
issn = {1532-8503 (Electronic); 1051-2276 (Linking)},
jid = {9112938},
journal = {J Ren Nutr},
jt = {Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation},
keywords = {CKD, Plant-Based Diet, Protein},
language = {eng},
lid = {S1051-2276(18)30154-7 {$[$}pii{$]$}; 10.1053/j.jrn.2018.06.006 {$[$}doi{$]$}},
lr = {20200618},
mh = {Acidosis/epidemiology; Amino Acids/deficiency; Animal Proteins, Dietary/adverse effects; Animals; Diet, Vegan; Energy Intake; Humans; Hyperphosphatemia/epidemiology; Hypertension/epidemiology; Kidney Failure, Chronic/diet therapy; *Nutritional Requirements; Plant Proteins, Dietary/*administration \& dosage; Renal Dialysis; Renal Insufficiency, Chronic/*diet therapy/therapy},
mhda = {2020/06/19 06:00},
month = {Mar},
number = {2},
own = {NLM},
pages = {112--117},
phst = {2018/04/17 00:00 {$[$}received{$]$}; 2018/06/20 00:00 {$[$}revised{$]$}; 2018/06/25 00:00 {$[$}accepted{$]$}; 2018/08/21 06:00 {$[$}pubmed{$]$}; 2020/06/19 06:00 {$[$}medline{$]$}; 2018/08/21 06:00 {$[$}entrez{$]$}},
pii = {S1051-2276(18)30154-7},
pl = {United States},
pmid = {30122652},
pst = {ppublish},
pt = {Journal Article},
rn = {0 (Amino Acids); 0 (Animal Proteins, Dietary); 0 (Plant Proteins, Dietary)},
sb = {IM},
status = {MEDLINE},
title = {Adequacy of Plant-Based Proteins in Chronic Kidney Disease.},
volume = {29},
year = {2019},
bdsk-url-1 = {https://doi.org/10.1053/j.jrn.2018.06.006}}