Should Chronic Kidney Disease Patients Be Switching To A Vegetarian Diet To Improve Outcomes?


Recent studies have demonstrated that reduction of animal protein intake and increased consumption of plant-based foods could influence cardiovascular risk profile and mortality rate which could "lead to some benefits for people with Chronic Kidney Disease (CKD)." Potential beneficial effects of a vegetarian diet include better phosphate balance, insulin sensitivity, and the control of metabolic acidosis (condition in which there is too much acid in the body fluids). On the other hand, drawbacks exist when a vegetarian diet is associated with protein intake that is too restrictive and/or insufficient energy intake. So anyone considering a vegetarian diet should schedule a regular nutritional follow-up with both their Nephrologist and a Dietitian.

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Despite innovations in dialysis related technology and advances in CKD treatment including anemia and bone disease, "perceptions about vegetarianism have not progressed as quickly," according to a recently published peer reviewed publication by the Renal Dietitians, Academy of Nutrition and Dietetics.  The suggested "old vegetarian myths" that plant protein is inferior to animal protein still remain. The publication suggests that myths include the belief that such a vegetarian diet could cause Phosphorus and Potassium levels to rise and that plant proteins do not meet the needs of the dialysis population. As a result, plant based diet options are not commonly offered to people with CKD.

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However the study found that although concern has been raised about Phosphorus in plant based foods, it is minor compared to the exponential increase in phosphate additives within the food supply and found in meat; increasing from 500mg per day in 1990 to 1000mg per day Today. The availability (biological availability) of Phosphorus to be absorbed into the body from meat protein is 70% while plant based Phosphorus is less than 50%. What's more is that the absorption of inorganic Phosphorus is increased to over 90% from processed foods including many flavored beverages, cereals, frozen meals and enhanced meat products.

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Potassium concerns "need not be a barrier for a patient to successfully follow a plant-based diet," the study postulates because Dieticians can suggest lower Potassium options such as tofu, seitan or lower Potassium beans (lentils, pinto or kidney beans) for people with CKD. Also adjustments can be made to the consumption of other fruits and vegetables to allow for better plant-based proteins.

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A recent study looked at vegetarian dialysis patients compared to non-vegetarians over six months and found no difference in albumin levels, hand grip strength or Subjective Global Assessment (proven nutritional assessment tool that has been found to be highly predictive of nutrition-associated complications) scores. This suggests that plant-based protein can be equal to meat-based protein in terms of quality and effectiveness.

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As CKD patients live longer, nutrition education needs to take into consideration diet choices for long-term protection and health. Introducing the healthy benefits of plant-based foods in easy-to-prepare and creative ways is one more approach to promote vitality, prevent co-morbid conditions as well as positively alter current health complications. People with CKD may choose to not adhere to a diet that is 100% vegetarian but adding plant-based options to a renal diet can still be beneficial to a patient's health.

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The findings presented in the Renal Nutrition Forum publication are that of the authors and not They state that "Plant-based proteins can be added easily and safely to our patient's diets, providing the same quality as animal protein with additional benefits." Still, whether you are on dialysis, in earlier stages CKD or a Transplant Recipient, strongly encourages you to discuss the matter with your Dietician BEFORE attempting to increase plant-based protein intake or altering your current diet in any way. 

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"The Benefits Of Vegetarina Diets In Chronic Kidney Disease." Renal Nutrition Forum - A Peer Reviewed  Publication of the Renal Dietitians Dietetic Practice Group.

"Vegetarianism: Advantages and Drawbacks in Patients With Chronic Kidney Diseases." Journal of Renal Nutrition.