For years, chronic kidney disease or kidney insufficiency has been treated with low protein and low phosphorous diets with the goal of delaying onset of dialysis.
In 2007, a Thai study compared renal (kidney) function parameters among non vegetarians and vegans (strict vegetarians). Of the studied parameters, it was found that vegans had significantly lower urine protein level – a sign of intact kidney function.[1]
It was not known if this was due to the vegans eating less protein than the omnivores, or if somehow the body is better able to handle plant protein than animal protein.
An American study in 2011 compared vegan dieters with omnivorous dieters, but controlled for calories, protein and phosphorous.
After 1 week of each of the diets, there was a higher serum phosphorous in the meat diet compared with the vegan diet.. There was also a trend for decreased urine pH and ammonium excretion in the meat versus vegan diet.[2]
The authors concluded that the study demonstrated that the source of protein has a significant effect on phosphorous homeostasis in patients with chronic kidney disease (CKD). Therefore, dietary counseling of patients with CKD must include information on not only the amount of phosphate, but also the source of protein from which the phosphate derives.
Another study showed that therapeutic diets using plant sources of protein are more effective in delaying the progression of renal insufficiency, compared to those using animal proteins[3].
Vegan diets have been shown to provide adequate protein. A study of 22 patients with mild renal failure compared a vegan diet to a conventional low-protein diet. All patients were followed for at least six months. There was no sign of protein insufficiency and inorganic phosphorous levels remained normal[4].
Patients with CKD are at a greater risk for heart attacks and strokes than the general population.[5] Because of this higher risk for arterial disease, the vast majority of patients with CKD die before progressing to end stage renal failure.
It appears to me that low fat WFPB diets such as the McDougall, Pritikin and Esselstyn models make the most sense for CKD sufferers. However, anyone with CKD should not adjust his/her diet without first consulting a registered dietitian who specializes in renal nutrition. For more information on plant based diets for CKD, click here for a nice resource from the Academy of Nutrition and Dietetics Vegetarian Practice Group.
[1] http://www.ncbi.nlm.nih.gov/pubmed/17365939
[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052214/
[3] http://www.ncbi.nlm.nih.gov/pubmed/2645923
[4] http://www.medscape.com/medline/abstract/8893161
[5] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742701/
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