Effects of Type of Protein Intake on Risk of Kidney Disease Progression among Patients with Nondialysis-Dependent CKD: A Systematic Review
Bibliographic record
Abstract
Background: While diets restricted in protein quantity are recommended by kidney nutrition guidelines, the effect of the type of protein on CKD progression is not known. Thus, we performed a systematic review to assess the effects of plant-based diets on CKD progression. Methods: We searched MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Center, Cochrane Central Register of Controlled Trials, Web of Science from January 1990-November 28, 2022. We included RCTs and observational studies with prospectively-collected data assessing type of protein in patients with non-dialysis CKD. The primary outcome was progression to kidney failure. Secondary outcomes included change in eGFR, albuminuria, all-cause mortality, quality of life.Two authors independently screened titles/abstracts, reviewed full text articles, and extracted data. Meta-analysis was not possible due to variability in outcome reporting and sparse data. Risk of bias was assessed using the Nutrition Quality Evaluation Strengthening Tools. Results: Eight studies assessing type of protein or dietary patterns emphasizing plant-based food were included. There were 3 RCTs (N=179 patients), which assessed soy protein (2 studies) and Mediterranean diet (1 study) vs. control diets. There were 5 cohort studies (N=4221) assessing plant-based protein intake (3 studies), Mediterranean diet score (1 study), and DASH diet score (1 study). While RCTs demonstrated inconsistency in eGFR outcome, cohort studies demonstrated that higher plant-based protein intake and higher DASH/Mediterranean diet scores were associated with lower risks of end-stage kidney disease and mortality (Figure). Risk of bias was high in RCTs due to selection bias. Conclusion: Our systematic review of type of protein on CKD progression demonstrated reduced risk of CKD progression in cohort studies, but RCT evidence was limited.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.011 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".