Low Protein Diets and Plant-Based Low Protein Diets: Do They Meet Protein Requirements of Patients with Chronic Kidney Disease?

Nutrients. 2020 Dec 29;13(1):83. doi: 10.3390/nu13010083.

Abstract

A low protein diet (LPD) has historically been used to delay uremic symptoms and decrease nitrogen (N)-derived catabolic products in patients with chronic kidney disease (CKD). In recent years it has become evident that nutritional intervention is a necessary approach to prevent wasting and reduce CKD complications and disease progression. While a 0.6 g/kg, high biological value protein-based LPD has been used for years, recent observational studies suggest that plant-derived LPDs are a better approach to nutritional treatment of CKD. However, plant proteins are less anabolic than animal proteins and amino acids contained in plant proteins may be in part oxidized; thus, they may not completely be used for protein synthesis. In this review, we evaluate the role of LPDs and plant-based LPDs on maintaining skeletal muscle mass in patients with CKD and examine different nutritional approaches for improving the anabolic properties of plant proteins when used in protein-restricted diets.

Keywords: CKD; amino acid; low protein diets; plant-based low protein diets.

Publication types

  • Review

MeSH terms

  • Aging
  • Amino Acids
  • Animal Proteins, Dietary*
  • Animals
  • Chronic Disease
  • Diet, High-Protein
  • Diet, Protein-Restricted*
  • Disease Progression
  • Humans
  • Muscle, Skeletal
  • Nitrogen
  • Plant Proteins / genetics
  • Plant Proteins, Dietary*
  • Renal Insufficiency, Chronic / diet therapy*
  • Sarcopenia

Substances

  • Amino Acids
  • Animal Proteins, Dietary
  • Plant Proteins
  • Plant Proteins, Dietary
  • Nitrogen