Abstract
Background and Objectives: High dietary protein intake can cause intraglomerular hypertension, which may result in kidney hyperfiltration, glomerular injury, and proteinuria. The quality of dietary protein may also play a role in kidney health. Several observational studies have shown that compared with protein from plant sources, animal protein is associated with an increased risk of end-stage chronic kidney disease (CKD). A plant dominant low-protein diet composed of ≥50% plant-based sources may lead to favorable changes in the gut microbiome, which can modulate uremic toxin generation and slow CKD progression, along with a reduction in cardiovascular risk. Phase angle (PhA) as a nutritional evaluation parameter is a reliable marker for estimating muscle health and quality of life scale in CKD patients. We evaluated the effect of a calorie restrictive plant dominant low-protein diet (PLADO) on the progression of renal failure and nutrition status in the patient case report. Methods: A 68-year-old female, obese (BMI 31.9 kg/m2) with CKD grades 3 presented to her primary care physicians in October 2022, changed her diet from an unhealthy Western diet to a personalized PLADO (protein 0.6–0.8 g/kg/day), caloric-restricted diet rich in fiber, according to basal metabolic rate (energy intake 1400 kcal/day) prescribed by a dietitian doctor. Liver and thyroid function and ferritin and potassium levels were within normal limits. Habitual dietary intake was estimated with a food frequency questionnaire and their body composition, and PhA was measured using a bioimpedance analysis (InBody 770; Seoul, Republic of Korea). The optimal PhA cut-off value was identified as ≤4.4 for non-dialysis patients. Results: After 3 months, serum urea, creatinine, uric acid, and glucose levels were significantly reduced, and hematological parameters and potassium levels were not significantly different. BMI, visceral fat, and total body fat % decreased, while PhA and skeletal muscle mass were stable. Conclusions: We confirmed that the PLADO diet with ≥50% plant protein can be safely recommended to patients with stage 3 CKD, as it slows down the progression of renal failure, and does not lead to a reduction in PhA. Therefore, there is a need for nephrology to include nutritional management of kidney disease in addition to the pharmacological axis.
Author Contributions
Case study design, D.R.-M. and B.P.; conducting study visits, D.R.-M. and S.P.; statistical analysis, M.P.; data interpretation, D.R.-M. and S.P.; writing- original draft preparation, D.R.-M.; writing- review and editing, V.V.; All authors contributed to the manuscript and approved the submitted version. All authors have read and agreed to the published version of the manuscript.
Funding
This research was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (No. 451-03-47/2023-01/200015).
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Informed consent was obtained from subject involved in the case study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author. The data is not publicly available due to data privacy.
Conflicts of Interest
The authors declare no conflict of interest.
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