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Open AccessFeature PaperReview

Vegetable-Based Diets for Chronic Kidney Disease? It Is Time to Reconsider

1
Medicine Department, Universitat de Barcelona, Institut d’Investigacions Biomèqiques August Pi i Sunyer, 08036 Barcelona, Spain
2
Servicio de Nefrología, Hospital da Costa, 27880 Burela, Spain
3
Servicio de Nefrología, Fundación Jiménez Díaz, 28040 Madrid, Spain
4
Centro de investigación en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
5
Red de Investigación Renal (RedinRen), 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(6), 1263; https://doi.org/10.3390/nu11061263
Received: 29 April 2019 / Revised: 23 May 2019 / Accepted: 30 May 2019 / Published: 4 June 2019
(This article belongs to the Special Issue Nutrients Intakes and Chronic Kidney Disease)
Traditional dietary recommendations to renal patients limited the intake of fruits and vegetables because of their high potassium content. However, this paradigm is rapidly changing due to the multiple benefits derived from a fundamentally vegetarian diet such as, improvement in gut dysbiosis, reducing the number of pathobionts and protein-fermenting species leading to a decreased production of the most harmful uremic toxins, while the high fiber content of these diets enhances intestinal motility and short-chain fatty acid production. Metabolic acidosis in chronic kidney disease (CKD) is aggravated by the high consumption of meat and refined cereals, increasing the dietary acid load, while the intake of fruit and vegetables is able to neutralize the acidosis and its deleterious consequences. Phosphorus absorption and bioavailability is also lower in a vegetarian diet, reducing hyperphosphatemia, a known cause of cardiovascular mortality in CKD. The richness of multiple plants in magnesium and vitamin K avoids their deficiency, which is common in these patients. These beneficial effects, together with the reduction of inflammation and oxidative stress observed with these diets, may explain the reduction in renal patients’ complications and mortality, and may slow CKD progression. Finally, although hyperkalemia is the main concern of these diets, the use of adequate cooking techniques can minimize the amount absorbed. View Full-Text
Keywords: CKD; vegetable-based diet; hyperkalemia; fiber; gut microbiota; dietary acid load; uremic toxins; phosphorus CKD; vegetable-based diet; hyperkalemia; fiber; gut microbiota; dietary acid load; uremic toxins; phosphorus
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MDPI and ACS Style

Cases, A.; Cigarrán-Guldrís, S.; Mas, S.; Gonzalez-Parra, E. Vegetable-Based Diets for Chronic Kidney Disease? It Is Time to Reconsider. Nutrients 2019, 11, 1263.

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