Dietary soya protein during pregnancy and lactation in rats with hereditary kidney disease attenuates disease progression in offspring

Cahill, Leah E.; Peng, Claudia Yu-Chen; Bankovic-Calic, Neda; Sankaran, Deepa; Ogborn, Malcolm R.; Aukema, Harold M.

doi:10.1017/s0007114507250470

Cited by 25 publications

(24 citation statements)

References 48 publications

(79 reference statements)

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“…Interestingly, the prevalence of small for gestational age babies was lower in on-diet patients as compared to patients on an unrestricted diet [168, 169]. The data obtained in a relatively small group of patients are in line with reports on the advantages of vegetal proteins in reducing kidney disease progression in non-pregnant humans, with a systematic review on vegan-vegetarian diets in pregnancy, and with the position of the American Dietary Association, provided that B12, iron and vitamin D are controlled and supplied upon need [170–178]. …”

Section: Specific Issues: Proteinuria and Low-protein Dietssupporting

confidence: 73%

A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

Castellino²,

et al. 2016

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Pregnancy is increasingly undertaken in patients with chronic kidney disease (CKD) and, conversely, CKD is increasingly diagnosed in pregnancy: up to 3 % of pregnancies are estimated to be complicated by CKD. The heterogeneity of CKD (accounting for stage, hypertension and proteinuria) and the rarity of several kidney diseases make risk assessment difficult and therapeutic strategies are often based upon scattered experiences and small series. In this setting, the aim of this position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature, and discuss the experience in the clinical management of CKD in pregnancy. CKD is associated with an increased risk for adverse pregnancy-related outcomes since its early stage, also in the absence of hypertension and proteinuria, thus supporting the need for a multidisciplinary follow-up in all CKD patients. CKD stage, hypertension and proteinuria are interrelated, but they are also independent risk factors for adverse pregnancy-related outcomes. Among the different kidney diseases, patients with glomerulonephritis and immunologic diseases are at higher risk of developing or increasing proteinuria and hypertension, a picture often difficult to differentiate from preeclampsia. The risk is higher in active immunologic diseases, and in those cases that are detected or flare up during pregnancy. Referral to tertiary care centres for multidisciplinary follow-up and tailored approaches are warranted. The risk of maternal death is, almost exclusively, reported in systemic lupus erythematosus and vasculitis, which share with diabetic nephropathy an increased risk for perinatal death of the babies. Conversely, patients with kidney malformation, autosomal-dominant polycystic kidney disease, stone disease, and previous upper urinary tract infections are at higher risk for urinary tract infections, in turn associated with prematurity. No risk for malformations other than those related to familiar urinary tract malformations is reported in CKD patients, with the possible exception of diabetic nephropathy. Risks of worsening of the renal function are differently reported, but are higher in advanced CKD. Strict follow-up is needed, also to identify the best balance between maternal and foetal risks. The need for further multicentre studies is underlined.

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Section: Specific Issues: Proteinuria and Low-protein Dietssupporting

confidence: 73%

A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

Castellino²,

et al. 2016

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“…Our previous study on a small series of patients on supplemented low-protein diets in pregnancy is one of the few available studies (31). Our data were in line with other reports on the advantages of vegetable proteins in reducing kidney disease progression rate in pregnant or lactating animals (31)(32)(33).…”

Section: Introductionsupporting

confidence: 90%

“…Studies in vegans underline the safety of this diet, provided that vitamin intake (mainly B12 and iron levels) and nutritional status are kept under control (47)(48)(49). The few available animal studies, performed on rats with genetic kidney diseases fed a soyaenriched diet, suggest an advantage for the offspring (32,33).…”

Section: Discussionmentioning

confidence: 99%

Association of Low-Protein Supplemented Diets with Fetal Growth in Pregnant Women with CKD

Piccoli¹,

Leone²,

Attini

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Women affected by CKD increasingly choose to get pregnant. Experience with lowprotein diets is limited. The aim of this study was to review results obtained from pregnant women with CKD on supplemented vegan-vegetarian low-protein diets.Design, setting, participants, & measurements This was a single-arm, open intervention study between 2000-2012 of a low-protein diet in pregnant patients with stages 3-5 CKD or severe proteinuria (.1 g/d in the first trimester or nephrotic at any time). Stages 3-5 CKD patients who were not on low-protein diets for clinical, psychologic, or logistic reasons served as controls. The setting was the Obstetrics-Nephrology Unit dedicated to kidney diseases in pregnancy. The treated group included 24 pregnancies-21 singleton deliveries, 1 twin pregnancy, 1 abortion, and 1 miscarriage. Additionally, there were 21 controls (16 singleton deliveries, 5 miscarriages). The diet was a vegan-vegetarian low-protein diet (0.6-0.8 g/kg per day) with keto-acid supplementation and 1-3 proteinunrestricted meals allowed per week.Results Treated patients and controls were comparable at baseline for median age (35 versus 34 years), referral week (7 versus 8), eGFR (59 versus 54 ml/min), and hypertension (43.5% versus 33.3%); median proteinuria was higher in patients on the low-protein diet (1.96 [0.1-6.3] versus 0.3 [0.1-2.0] g/d; P,0.001). No significant differences were observed in singletons with regard to gestational week (34 versus 36) or Caesarean sections (76.2% versus 50%). Kidney function at delivery was not different, but proteinuria was higher in the diet group. Incidence of small for gestational age babies was significantly lower in the diet group (3/21) versus controls (7/16; chi-squared test; P=0.05). Throughout follow-up (6 months to 10 years), hospitalization rates and prevalence of children below the third percentile were similar in both groups.Conclusion Vegan-vegetarian supplemented low-protein diets in pregnant women with stages 3-5 CKD may reduce the likelihood of small for gestational age babies without detrimental effects on kidney function or proteinuria in the mother.

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“…A trend towards better preserved fetal growth was observed. Results of animal studies suggest that the beneficial effects of vegetable proteins and supplementation with ketoacids is associated with endothelium protective properties of ketoacids in rats with kidney disease and a decrease in the risk of CKD in the offspring of rats with genetic kidney diseases that are fed a soy rich diet [79,80]. …”

Section: The Safety Of Vegetarian Dietmentioning

confidence: 99%

Vegetarian Diet in Chronic Kidney Disease—A Friend or Foe

Gluba-Brzózka¹,

Franczyk

Rysz

2017

Nutrients

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Healthy diet is highly important, especially in patients with chronic kidney disease (CKD). Proper nutrition provides the energy to perform everyday activities, prevents infection, builds muscle, and helps to prevent kidney disease from getting worse. However, what does a proper diet mean for a CKD patient? Nutrition requirements differ depending on the level of kidney function and the presence of co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. The diet of CKD patients should help to slow the rate of progression of kidney failure, reduce uremic toxicity, decrease proteinuria, maintain good nutritional status, and lower the risk of kidney disease-related secondary complications (cardiovascular disease, bone disease, and hypertension). It has been suggested that plant proteins may exert beneficial effects on blood pressure, proteinuria, and glomerular filtration rate, as well as results in milder renal tissue damage when compared to animal proteins. The National Kidney Foundation recommends vegetarianism, or part-time vegetarian diet as being beneficial to CKD patients. Their recommendations are supported by the results of studies demonstrating that a plant-based diet may hamper the development or progression of some complications of chronic kidney disease, such as heart disease, protein loss in urine, and the progression of kidney damage. However, there are sparse reports suggesting that a vegan diet is not appropriate for CKD patients and those undergoing dialysis due to the difficulty in consuming enough protein and in maintaining proper potassium and phosphorus levels. Therefore, this review will focus on the problem as to whether vegetarian diet and its modifications are suitable for chronic kidney disease patients.

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Dietary soya protein during pregnancy and lactation in rats with hereditary kidney disease attenuates disease progression in offspring

Cited by 25 publications

References 48 publications

A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

Association of Low-Protein Supplemented Diets with Fetal Growth in Pregnant Women with CKD

Vegetarian Diet in Chronic Kidney Disease—A Friend or Foe

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