Plant-based diets to manage the risks and complications of chronic kidney disease
Por:
Carrero JJ, González-Ortiz A, Avesani CM, Bakker SJL, Bellizzi V, Chauveau P, Clase CM, Cupisti A, Espinosa-Cuevas A, Molina P, Moreau K, Piccoli GB, Post A, Sezer S and Fouque D
Publicada:
1 sep 2020
Ahead of Print:
1 jun 2020
Categoría:
Nephrology
Resumen:
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.
Emerging evidence suggests that plant-based diets could help to prevent chronic kidney disease (CKD), manage its symptoms and metabolic complications and delay disease progression. Here, the authors discuss the potential risks and benefits of these diets in patients with CKD, as well as implementation strategies and knowledge gaps.
Filiaciones:
Carrero JJ:
Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
González-Ortiz A:
Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador, Zubirán, Mexico
Avesani CM:
Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
Bakker SJL:
Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Bellizzi V:
Nephrology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
Chauveau P:
Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France
Clase CM:
Departments of Medicine and Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
Cupisti A:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Espinosa-Cuevas A:
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
Moreau K:
Renal transplant unit, Pellegrin Hospital, Bordeaux, France
Piccoli GB:
Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
Nephrologie, Centre Hospitalier Le Mans, Le Mans, France
Post A:
Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Sezer S:
Department of Nephrology, Baskent University School of Medicine, Ankara, Turkey
Fouque D:
Department of Nephrology, Université de Lyon, Carmen, Hospital Lyon-Sud, Lyon, France
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