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Cited by 115Parathyroid Disorders and TreatmentsRenal function and acid-base balanceChronic Kidney Disease and Diabetes

Plant protein intake is associated with fibroblast growth factor 23 and serum bicarbonate levels in patients with chronic kidney disease: The Chronic Renal Insufficiency Cohort study

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Scialla, Julia J., Appel, Lawrence J., Wolf, Myles, Yang, Wei, Zhang, Xiaoming, Sozio, Stephen M., Miller, Edgar R., Bazzano, Lydia A. +8 more·2012·Journal of Renal Nutrition
DOI 10.1053/j.jrn.2012.01.026PMC PMC3383455
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Abstract

Background Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD) because of the lower bioavailability of phosphate and lower nonvolatile acid load.Study design Observational cross-sectional study.Setting and participants A total of 2,938 participants with CKD and information on their dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study.Predictors Percentage of total protein intake from plant sources (percent plant protein) was determined by scoring individual food items using the National Cancer Institute Diet History Questionnaire (DHQ).Outcomes Metabolic parameters, including serum phosphate, bicarbonate (HCO₃), potassium, and albumin, plasma fibroblast growth factor 23 (FGF-23), and parathyroid hormone (PTH), and hemoglobin levels.Measurements We modeled the association between percent plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes status, body mass index, estimated glomerular filtration rate, income, smoking status, total energy intake, total protein intake, 24-hour urinary sodium concentration, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and use of diuretics.Results Higher percent plant protein was associated with lower FGF-23 (P = .05) and higher HCO₃ (P = .01) levels, but not with serum phosphate or parathyroid hormone concentrations (P = .9 and P = .5, respectively). Higher percent plant protein was not associated with higher serum potassium (P = .2), lower serum albumin (P = .2), or lower hemoglobin (P = .3) levels. The associations of percent plant protein with FGF-23 and HCO₃ levels did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5), or total protein intake (≤0.8 g/kg/day vs. >0.8 g/kg/day; P-interaction >.10 for each).Limitations This is a cross-sectional study; determination of percent plant protein using the Diet History Questionnaire has not been validated.Conclusions Consumption of a higher percentage of protein from plant sources may lower FGF-23 and raise HCO₃ levels in patients with CKD.

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  • The Chronic Renal Insufficiency Cohort Study indicates an association between plant protein consumption and reduction in metabolic risk factors for CKD.

    “The observational outcomes of the Chronic Renal Insufficiency Cohort Study supported these findings to indicate an association between plant protein consumption and reduction in metabolic risk factors for CKD exists [104].”

    From Plant Proteins: Assessing Their Nutritional Quality and Effects on Health and Physical Function (2020) · cites this paper as [104]

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Authors
Scialla, J. J., Appel, L. J., Wolf, M., Yang, W., Zhang, X., Sozio, S. M., Miller, E. R., Bazzano, L. A., Cuevas, M., Glenn, M. J., Lustigova, E., Kallem, R. R., Porter, A. C., Townsend, R. R., Weir, M. R., & Anderson, C. A. M.
Affiliations
  • University of Miami (US)
  • Johns Hopkins University (US)
  • University of Pennsylvania (US)
  • Tulane University (US)
  • University of Illinois Chicago (US)
  • University of Maryland, Baltimore (US)
Corresponding author
Scialla, Julia J.
ORCID
Venue
Journal of Renal Nutrition
Publisher
Elsevier BV
Published
2012-07
Volume
22
Issue
4
Pages
379-388.e1
ISSN
1051-2276 (ISSN-L)
DOI
10.1053/j.jrn.2012.01.026
PMC
PMC3383455
OpenAlex
W2048336620
Cited by
115
References
47
Citations by year
2026: 1 · 2025: 4 · 2024: 7 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 11 · 2019: 10 · 2018: 8 · 2017: 13 · 2016: 13 · 2015: 4 · 2014: 4 · 2013: 7 · 2012: 1
FWCI
4.04
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Renal Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute (K01HL092595)
  • National Institute of Diabetes and Digestive and Kidney Diseases (5U01DK06102, R01DK076116, U01DK060990, 5U01 DK60980, K24DK093723, R01DK081374, L30 DK084874, U01DK060984, U01DK060902, U01DK060980, U01DK060963, U01DK061021, U01DK061028)
  • National Center for Research Resources (UL1RR024131, RR-05096, UL1RR024989, UL1RR025005, M01RR016500, UL1RR024986, UL1RR024134, UL1RR029879, M01RR005096, KL2RR025006, M01RR 16500, M01RR000042)
Topics
  • Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
  • Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
plant protein intake, fibroblast growth factor 23, serum bicarbonate, chronic kidney disease, dietary protein, serum phosphorus, parathyroid hormone, serum potassium, serum albumin, hemoglobin, phosphate bioavailability, Chronic Renal Insufficiency Cohort Study, diet history questionnaire, diabetes status, race and sex differences, CKD stage
MeSH terms
Fibroblast Growth Factor-23, Adult, Aged, Bicarbonates, Cross-Sectional Studies, Diet, Female, Fibroblast Growth Factors, Hemoglobins, Humans, Kidney Failure, Chronic, Male, Middle Aged, Parathyroid Hormone, Plant Proteins, Serum Albumin, Cohort Studies, Young Adult

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