Plant-based Diet and Chronic Kidney Disease: A Systematic Review and Meta-analysis.

Objective: We aimed to perform a systematic review and meta-analyses to evaluate the impact of plant-based diet (PBD) on chronic kidney disease (CKD).

Methods: A systematic search of PubMed and Embase was conducted from inception to August 2023 to evaluate the association between adopting a PBD and the incidence, progression, and mortality of CKD. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. This meta-analysis was pre-registered in the PROSPERO.

Results: A total of 121,927 participants were included, aged between 18 and 74 years, and were followed up for a weighted average of 11.2 years. Adopting PBD is associated with a significantly reduced risk of developing CKD OR=0.75, 95% CI (0.65, 0.86), P<0.0001] across 93,857 participants. Similar results were observed in subgroup analyses that examined higher quintiles/quartiles (Q2-Q5) and tertiles (T2-T3) of PBD vs Q1/T1, with overall effect measures of 0.92 (95% CI; 0.86 to 0.98) and 0.88 (95% CI; 0.82 to 0.93), respectively. When adjusting for CKD-related comorbidities in patients following PBD (adjusted models M1, M2, and M3), significant findings were also observed, with an overall OR of 0.86 (95% CI: 0.79 to 0.93).

Conclusion: Adopting PBD was significantly associated with 26% lower incidences of CKD. Higher intake of PBD showed a dose-dependent relationship with lower risk of CKD incidence and slower CKD progression. Unhealthy PBD may not confer renal protective effects compared to healthy PBD.