Plant-based low-protein diet for preventing malnutrition‒inflammation complex syndrome in adults with CKD: a single-centre preliminary experience

Background: Chronic kidney disease (CKD) is a rising public health concern. Low protein intake reduces uremic toxin generation and improves the hemodynamic profile of the kidneys, postponing the need for eventual dialysis. Vegetarian diets have been shown to positively influence cardiovascular health and reduce uremic toxin levels and inflammation in CKD patients. The so-called “Malnutrition-Inflammation Complex Syndrome” (MICS) is a nontraditional cardiovascular risk factor that is associated with poor overall outcomes in CKD patients. The type of protein, not only the amount, may be relevant in the prevention of MICS, but at present no studies are published in the literature addressing this topic. The aim of our study was to evaluate the feasibility and efficacy of a plant-based diet in reducing CKD-related complications and preventing MICS. Methods: Adult subjects with CKD (3–5 stages) were retrospectively recruited. Each patient was evaluated for biochemical parameters, anthropometric measurements, body composition, and pharmacological treatments at baseline and after 6 months of dietary intervention. Results: After six months of treatment, significant improvements (p < 0.05) were observed in indices of kidney function, lipid and glycemic profiles, vitamin D levels, plasma fibrinogen, anthropometric and body composition parameters, as well as muscle strength, whereas no significant changes were detected in plasma albumin levels or in the other parameters assessed. As observed in recent literature, the risk of hyperkalaemia associated with plant-based regimens in CKD patients has been set aside. Conclusions: Our preliminary study confirms the feasibility and efficacy of a plant-based diet in reducing CKD-related complications and preventing MICS.