Summary of findings 1. Low protein diet versus normal protein diet for non‐diabetic adults with chronic kidney disease (CKD).
| Low protein diet versus normal protein diet for non‐diabetic adults with CKD | |||||
| Patient or population: non‐diabetic adults with CKD Setting: all settings Intervention: low protein diet Comparison: normal protein diet | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with normal protein diet | Risk with low protein diet | ||||
| Death (all causes) | 55 per 1,000 | 42 per 1,000 (28 to 65) | RR 0.77 (0.51 to 1.18) | 1680 (5) | ⊕⊕⊕⊝ MODERATE 1 |
| ESKD | 144 per 1,000 | 151 per 1,000 (105 to 220) | RR 1.05 (0.73 to 1.53) | 1814 (6) | ⊕⊕⊝⊝ LOW 1 2 |
| End or change in GFR | The SMD for end or change in GFR was 0.18 lower (0.75 lower to 0.38 higher) with low protein diet compared to normal protein diet | ‐ | 1680 (8) | ⊕⊝⊝⊝ VERY LOW 1 2 3 | |
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; ESKD: end‐stage kidney disease; GFR: glomerular filtration rate; SMD ‐ standardised mean difference | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 The confidence intervals include potential for important benefits and harms
2 Important and unexplained heterogeneity present
3 The outcome reported is a surrogate outcome