Next Article in Journal
Effect of Red Ginseng on Genotoxicity and Health-Related Quality of Life after Adjuvant Chemotherapy in Patients with Epithelial Ovarian Cancer: A Randomized, Double Blind, Placebo-Controlled Trial
Next Article in Special Issue
Dietary Approaches in the Management of Diabetic Patients with Kidney Disease
Previous Article in Journal
Whole Grain Intake and Glycaemic Control in Healthy Subjects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Previous Article in Special Issue
Body Composition Analysis Allows the Prediction of Urinary Creatinine Excretion and of Renal Function in Chronic Kidney Disease Patients
Article Menu
Issue 7 (July) cover image

Export Article

Open AccessCase Report
Nutrients 2017, 9(7), 770; doi:10.3390/nu9070770

Pregnancy, Proteinuria, Plant-Based Supplemented Diets and Focal Segmental Glomerulosclerosis: A Report on Three Cases and Critical Appraisal of the Literature

1
Materno-Foetal Unit, Department of Surgery, University of Torino, 10100 Turin, Italy
2
SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Turin, Italy
3
SCDU Nephrology, Giovanni Bosco Hospital, University of Torino, 10100 Turin, Italy
4
Department of Medical Sciences, University of Torino, 10100 Turin, Italy
5
Department of Biological and Clinical Sciences, University of Torino, 10100 Turin, Italy
6
Nephrology, Centre Hospitalier Le Mans, 72000 Le Mans, France
*
Author to whom correspondence should be addressed.
Received: 19 February 2017 / Revised: 6 July 2017 / Accepted: 10 July 2017 / Published: 19 July 2017
(This article belongs to the Special Issue Nutrition and Chronic Kidney Disease)
View Full-Text   |   Download PDF [5594 KB, uploaded 19 July 2017]   |  

Abstract

Chronic kidney disease (CKD) is increasingly recognized in pregnant patients. Three characteristics are associated with a risk of preterm delivery or small for gestational age babies; kidney function reduction, hypertension, and proteinuria. In pregnancy, the anti-proteinuric agents (ACE–angiotensin converting enzyme-inhibitors or ARBS -angiotensin receptor blockers) have to be discontinued for their potential teratogenicity, and there is no validated approach to control proteinuria. Furthermore, proteinuria usually increases as an effect of therapeutic changes and pregnancy-induced hyperfiltration. Based on a favourable effect of low-protein diets on proteinuria and advanced CKD, our group developed a moderately protein-restricted vegan-vegetarian diet tsupplemented with ketoacids and aminoacids for pregnant patients. This report describes the results obtained in three pregnant patients with normal renal function, nephrotic or sub-nephrotic proteinuria, and biopsy proven diagnosis of focal segmental glomerulosclerosis, a renal lesion in which hyperfiltration is considered of pivotal importance (case 1: GFR (glomerular filtration rate): 103 mL/min; proteinuria 2.1 g/day; albumin 3.2 g/dL; case 2: GFR 86 mL/min, proteinuria 3.03 g/day, albumin 3.4 g/dL; case 3: GFR 142 mL/min, proteinuria 6.3 g/day, albumin 3.23 g/dL). The moderately restricted diet allowed a stabilisation of proteinuria in two cases and a decrease in one. No significant changes in serum creatinine and serum albumin were observed. The three babies were born at term (38 weeks + 3 days, female, weight 3180 g-62th centile; 38 weeks + 2 days, female, weight 3300 g-75th centile; male, 38 weeks + 1 day; 2770 g-8th centile), thus reassuring us of the safety of the diet. In summary, based on these three cases studies and a review of the literature, we suggest that a moderately protein-restricted, supplemented, plant-based diet might contribute to controlling proteinuria in pregnant CKD women with focal segmental glomerulosclerosis. However further studies are warranted to confirm the potential value of such a treatment strategy. View Full-Text
Keywords: vegan diet; plant-based diet; proteinuria; chronic kidney disease; focal segmental glomerulosclerosis; pregnancy; preterm delivery; hyperfiltration; low protein diets vegan diet; plant-based diet; proteinuria; chronic kidney disease; focal segmental glomerulosclerosis; pregnancy; preterm delivery; hyperfiltration; low protein diets
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Attini, R.; Leone, F.; Montersino, B.; Fassio, F.; Minelli, F.; Colla, L.; Rossetti, M.; Rollino, C.; Alemanno, M.G.; Barreca, A.; Todros, T.; Piccoli, G.B. Pregnancy, Proteinuria, Plant-Based Supplemented Diets and Focal Segmental Glomerulosclerosis: A Report on Three Cases and Critical Appraisal of the Literature. Nutrients 2017, 9, 770.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top