Effects of a Low-Protein Diet on Kidney Function in Patients With Chronic Kidney Disease: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials.

IF 5.9 2区 医学 Q1 NUTRITION & DIETETICS
Reza Amiri Khosroshahi, Marzieh Zare, Sheida Zeraattalab-Motlagh, Fatemeh Kiany, Sepide Talebi, Hamed Mohammadi
{"title":"Effects of a Low-Protein Diet on Kidney Function in Patients With Chronic Kidney Disease: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials.","authors":"Reza Amiri Khosroshahi, Marzieh Zare, Sheida Zeraattalab-Motlagh, Fatemeh Kiany, Sepide Talebi, Hamed Mohammadi","doi":"10.1093/nutrit/nuae178","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Chronic kidney disease (CKD) stands out as one of the most widespread diseases globally. Dietary interventions, such as adopting a low-protein diet (LPD), play a crucial role as a key approach in impeding the advancement of CKD.</p><p><strong>Objective: </strong>The objective of this umbrella review was to provide understanding into the effects of an LPD on kidney function among individuals with CKD, along with evaluating the certainty of the available evidence.</p><p><strong>Data sources: </strong>Searches for relevant studies were conducted without limitations through databases such as PubMed, Scopus, Web of Science, and Google Scholar, encompassing findings up to June 2023.</p><p><strong>Data extraction: </strong>The effect sizes for each meta-analysis were recalibrated using a random-effects model. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Data analysis: </strong>Twenty-five meta-analyses including 47 randomized controlled trials were included in this study. Moderate certainty of the evidence suggests that LPDs may reduce glycated hemoglobin (HbA1c) and phosphorus levels, and the risk of progressing to end-stage renal disease in patients with CKD. Moreover, notable outcomes include increased glomerular filtration rate and decreased levels of serum albumin, blood urea nitrogen, and bicarbonate, although the certainty of evidence is low. In addition, LPDs can substantially decrease proteinuria, urine urea, and parathyroid hormone (PTH), although with very low certainty. The effects on serum creatinine, calcium, systolic blood pressure, and diastolic blood pressure are statistically nonsignificant, with the certainty of evidence ranging from low to moderate.</p><p><strong>Conclusion: </strong>LPDs demonstrated beneficial effects on renal function in patients with CKD, which is supported by moderate to very low certainty evidence.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. CRD42023473647.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/nutrit/nuae178","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0

Abstract

Context: Chronic kidney disease (CKD) stands out as one of the most widespread diseases globally. Dietary interventions, such as adopting a low-protein diet (LPD), play a crucial role as a key approach in impeding the advancement of CKD.

Objective: The objective of this umbrella review was to provide understanding into the effects of an LPD on kidney function among individuals with CKD, along with evaluating the certainty of the available evidence.

Data sources: Searches for relevant studies were conducted without limitations through databases such as PubMed, Scopus, Web of Science, and Google Scholar, encompassing findings up to June 2023.

Data extraction: The effect sizes for each meta-analysis were recalibrated using a random-effects model. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Data analysis: Twenty-five meta-analyses including 47 randomized controlled trials were included in this study. Moderate certainty of the evidence suggests that LPDs may reduce glycated hemoglobin (HbA1c) and phosphorus levels, and the risk of progressing to end-stage renal disease in patients with CKD. Moreover, notable outcomes include increased glomerular filtration rate and decreased levels of serum albumin, blood urea nitrogen, and bicarbonate, although the certainty of evidence is low. In addition, LPDs can substantially decrease proteinuria, urine urea, and parathyroid hormone (PTH), although with very low certainty. The effects on serum creatinine, calcium, systolic blood pressure, and diastolic blood pressure are statistically nonsignificant, with the certainty of evidence ranging from low to moderate.

Conclusion: LPDs demonstrated beneficial effects on renal function in patients with CKD, which is supported by moderate to very low certainty evidence.

Systematic review registration: PROSPERO registration no. CRD42023473647.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Nutrition reviews
Nutrition reviews 医学-营养学
CiteScore
12.20
自引率
1.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信