Comparison of high vs. normal/low protein diets on renal function in subjects without chronic kidney disease: a systematic review and meta-analysis

PLoS One. 2014 May 22;9(5):e97656. doi: 10.1371/journal.pone.0097656. eCollection 2014.

Abstract

Background: It was the aim of the present systematic review and meta-analysis to investigate the effects of high protein (HP) versus normal/low protein (LP/NP) diets on parameters of renal function in subjects without chronic kidney disease.

Methods: Queries of literature were performed using the electronic databases MEDLINE, EMBASE, and the Cochrane Trial Register until 27th February 2014. Study specific weighted mean differences (MD) were pooled using a random effect model by the Cochrane software package Review Manager 5.1.

Findings: 30 studies including 2160 subjects met the objectives and were included in the meta-analyses. HP regimens resulted in a significantly more pronounced increase in glomerular filtration rate [MD: 7.18 ml/min/1.73 m2, 95% CI 4.45 to 9.91, p<0.001], serum urea [MD: 1.75 mmol/l, 95% CI 1.13 to 237, p<0.001], and urinary calcium excretion [MD: 25.43 mg/24h, 95% CI 13.62 to 37.24, p<0.001] when compared to the respective LP/NP protocol.

Conclusion: HP diets were associated with increased GFR, serum urea, urinary calcium excretion, and serum concentrations of uric acid. In the light of the high risk of kidney disease among obese, weight reduction programs recommending HP diets especially from animal sources should be handled with caution.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Calcium / urine
  • Diet / adverse effects
  • Diet / methods*
  • Diet, Carbohydrate-Restricted
  • Diet, Protein-Restricted / adverse effects
  • Diet, Protein-Restricted / methods
  • Dietary Proteins / metabolism*
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiology*
  • Kidney Diseases / etiology
  • Urea / blood

Substances

  • Dietary Proteins
  • Urea
  • Calcium

Grant support

The authors have no support or funding to report.