Is low-protein diet a possible risk factor of malnutrition in chronic kidney disease patients?
Open accessAbstract
Chronic kidney disease (CKD) is becoming increasingly widespread in the world. Slowing its progression means to prevent uremic complications and improve quality of life of patients. Currently, a low-protein diet (LPD) is one of the tools most used in renal conservative therapy but a possible risk connected to LPD is protein-energy wasting. The aim of this study is evaluate the possible correlation between LPD and malnutrition onset. We enrolled 41 CKD patients, stages IIIb/IV according to K-DIGO guidelines, who followed for 6 weeks a diet with controlled protein intake (recommended dietary allowance 0.7 g per kilogram Ideal Body Weight per day of protein). Our patients showed a significant decrease of serum albumin values after 6 weeks of LDP (T2) compared with baseline values (T0) (P=0.039), whereas C-reactive protein increased significantly (T0 versus T2; P=0.131). From body composition analysis, a significant impairment of fat-free mass percentage at the end of the study was demonstrated (T0 versus T2; P=0.0489), probably related to total body water increase. The muscular mass, body cell mass and body cell mass index are significantly decreased after 6 weeks of LDP (T2). The phase angle is significantly reduced at the end of the study compared with basal values (T0 versus T2; P=0.0001, and T1 versus T2; P=0.0015). This study indicated that LPD slows down the progression of kidney disease but worsens patients' nutritional state.
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The study could not be certain about hydration status because DXA examination does not quantify hydration status.
“However, having only performed DXA examination to measure body composition [39] we cannot be certain, as this instrument does not quantify hydration status.”
From MOSH Syndrome (Male Obesity Secondary Hypogonadism): Clinical Assessment and Possible Therapeutic Approaches (2018) · cites this paper as [39]
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- Authors
- Noce, A., Vidiri, M. F., Marrone, G., Moriconi, E., Bocedi, A., Capria, A., Rovella, V, Ricci, G., De Lorenzo, A., & Di Daniele, N.
- Affiliations
- University of Rome Tor Vergata (IT)
- Venue
- Cell Death Discovery
- Published
- 2016-05-09
- Volume
- 2
- Issue
- 1
- Pages
- 16026-16026
- ISSN
- 2058-7716 (ISSN-L)
- PMC
- PMC4979484
- OpenAlex
- W2346867002
- Cited by
- 72
- References
- 46
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 4 · 2022: 12 · 2021: 10 · 2020: 2 · 2019: 11 · 2018: 6 · 2017: 5 · 2016: 2
- FWCI
- 8.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cell Death Discovery (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- low-protein diet, chronic kidney disease, malnutrition, protein-energy wasting, serum albumin, C-reactive protein, body composition, fat-free mass, phase angle, body cell mass, kidney disease progression
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