ReviewBMC nephrology2016
North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease.
Review in BMC nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2018Pooled it
- Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials.Journal of cachexia, sarcopenia and muscle · 2018Pooled it
- Effects of keto acid supplements on Chinese patients receiving maintenance hemodialysis: a prospective, randomized, controlled, single-center clinical study.Chinese medical journal · 2020Trial
- Trial
- Development and Validation of the Treatment Adherence Scale for Non-Dialysis Chronic Kidney Disease Patients in China: A Mixed-Methods Study.Patient preference and adherence · 2026Article
- Type 2 diabetes mellitus with chronic kidney disease benefits from long-term restriction of dietary protein intake: a 10-year retrospective cohort study.BMC nutrition · 2025Article
- Review
- A Plant-Dominant Low-Protein Diet in Chronic Kidney Disease Management: A Narrative Review with Considerations for Cyprus.Nutrients · 2025Review
- Development and validation of a questionnaire for the knowledge assessment and management of PLADO diet in kidney and healthy population in Cyprus.Frontiers in nutrition · 2025Article
- High Protein Diets and Glomerular Hyperfiltration in Athletes and Bodybuilders: Is Chronic Kidney Disease the Real Finish Line?Sports medicine (Auckland, N.Z.) · 2024Review
- Review
- Continued elevation of creatinine and uric acid in a male athlete: A case report.SAGE open medical case reports · 2024Article
- Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2023Review
- Rationale and Design of the Diet, CKD, and Apolipoprotein L1 Study in Low-Income and Middle-Income Countries.Kidney international reports · 2023Article
- An investigation of low-protein diets' qualification rates and an analysis of their short-term effects for patients with CKD stages 3-5: a single-center retrospective cohort study from China.International urology and nephrology · 2023Article
- Use of low-protein staple foods in the dietary management of patients with stage 3-4 chronic kidney disease: a prospective case-crossover study.BMC nephrology · 2022Article
- The Association Between Total Protein Intake and All-Cause Mortality in Middle Aged and Older Korean Adults With Chronic Kidney Disease.Frontiers in nutrition · 2022Article
- Fermented Soy and Fish Protein Dietary Sources Shape Ileal and Colonic Microbiota, Improving Nutrient Digestibility and Host Health in a Piglet Model.Frontiers in microbiology · 2022Article
- Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease.Frontiers in pharmacology · 2022Review
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 1 country.
Funding
Abstract
Whereas in many parts of the world a low protein diet (LPD, 0.6-0.8 g/kg/day) is routinely prescribed for the management of patients with non-dialysis-dependent chronic kidney disease (CKD), this practice is infrequent in North America. The historical underpinnings related to LPD in the USA including the non-conclusive results of the Modification of Diet in Renal Disease Study may have played a role. Overall trends to initiate dialysis earlier in the course of CKD in the US allowed less time for LPD prescription. The usual dietary intake in the US includes high dietary protein content, which is in sharp contradistinction to that of a LPD. The fear of engendering or worsening protein-energy wasting may be an important handicap as suggested by a pilot survey of US nephrologists; nevertheless, there is also potential interest and enthusiasm in gaining further insight regarding LPD's utility in both research and in practice. Racial/ethnic disparities in the US and patients' adherence are additional challenges. Adherence should be monitored by well-trained dietitians by means of both dietary assessment techniques and 24-h urine collections to estimate dietary protein intake using urinary urea nitrogen (UUN). While keto-analogues are not currently available in the USA, there are other oral nutritional supplements for the provision of high-biologic-value proteins along with dietary energy intake of 30-35 Cal/kg/day available. Different treatment strategies related to dietary intake may help circumvent the protein- energy wasting apprehension and offer novel conservative approaches for CKD management in North America.
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