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. 2023 Sep 22;12(19):6137. doi: 10.3390/jcm12196137

Table 2.

RCTs on plant-based low-protein diets in non-dialysis-dependent chronic kidney disease (NDD-CKD).

Type of Study Patients and Time Comparing Diets Results Possible Bias
Prospective randomized controlled trial
(Milovanova LY et al., 2023) [113]		 85 CKD 3b-4 stages (12 months) Soy LPD + KA versus traditional LPD + KA Soy LPD + KA showed:
  • -

    Slower decrease in eGFR;

  • -

    Lower increase in left ventricle hypertrophy and better blood pressure control;

  • -

    Better maintenance of lean body mass;

  • -

    Improved urea and phosphorus and cholesterol levels.
Prospective randomized controlled clinical study
(Feiten SF et al., 2005) [114]		 24 patients eGFR < 25 mL/min
(4 months)		 VLPDs versus conventional LPD
  • -

    Both maintain the nutritional status;

  • -

    Only VLPDs showed improvement in calcium and phosphorus metabolism and a reduction in serum urea nitrogen.
Prospective multicentre randomized controlled study
(Brunori G. et al., 2007) [115]		 56 uremic non-diabetic patients older than 70 years with eGFR of 5 to 7 mL/min
(median follow-up was 26.5 months)		 VLPDs versus dialysis
  • -

    VLPDs allowed for the postponement of dialysis for about 11 months without increasing mortality.
Prospective randomized crossover-controlled trial
(Di Iorio BR et al., 2018) [116]		 60 patients on
CKD stage 3b-4
(18 months)		 Free diet (FD), Mediterranean diet (MD), and VLPDs MD and VLPDs versus FD showed:
  • -

    Lower diastolic blood pressure;

  • -

    Lower urea, sodium, phosphorus and PTH;

  • -

    Higher serum levels of bicarbonate and haemoglobin;

  • -

    Lower lysine and homocitrulline/lysin ratio (markers of cyanate levels).
Prospective randomized controlled trial
(Garneata L et al., 2016) [117]		 207 non-diabetic adults with stable eGFR < 30 mL/min
(18 months)		 VLPDs versus conventional LPD Patients on a VLPDs showed:
  • -

    Reduced risk of halving initial eGFR or dialysis initiation;

  • -

    Lower serum urea and serum phosphorus;

  • -

    Reduced need of calcium, bicarbonate, and vitamin D supplements.
Prospective randomized controlled trial
(Bellizzi V et al., 2022) [119]		 233 patients (diabetics included) with CKD stage 4 or 5
(36 months)		 VLPDs versus conventional LPD VLPDs resulted in safe nutrition but without any benefit with regard to renal survival and metabolic parameters. Low adherence to diet (only 3 patients followed the prescribed 0.3 g/kg/day of protein intake)

LPD + KA: Low Protein Diet plus Keto Analogues. eGFR: estimated Glomerular Filtration Rate. LPD: Low Protein Diet. VLPDs: Very Low Protein Diet supplemented.