Dietary Protein Intake and Bone Across Stages of Chronic Kidney Disease

被引:7
|
作者
Stremke, Elizabeth R. [1 ]
Biruete, Annabel [2 ,3 ]
Gallant, Kathleen M. Hill [1 ,2 ]
机构
[1] Purdue Univ, Dept Nutr Sci, W Lafayette, IN 47907 USA
[2] Indiana Univ Sch Med, Div Nephrol, Dept Med, Indianapolis, IN 46202 USA
[3] Indiana Univ Sch Med, Dept Anat & Cell Biol, Indianapolis, IN 46202 USA
基金
美国国家卫生研究院;
关键词
Nutrition; Low protein diets; Alpha-keto acid analogue supplementation; Chronic kidney disease-mineral bone disorder; RENAL-DISEASE; ACID LOAD; RESTRICTION; PROGRESSION; PHOSPHORUS; CALCIUM; CKD; ADULTS; CLASSIFICATION; FRACTURES;
D O I
10.1007/s11914-020-00581-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review This review aims to summarize the current evidence on the effect of very-low-, low-, and high-protein diets on outcomes related to chronic kidney disease-mineral and bone disorder (CKD-MBD) and bone health in patients with CKD. Recent Findings Dietary protein restriction in the form of low- and very-low-protein diets have been used to slow down the progression of CKD. These diets can be supplemented with alpha-keto acid (KA) analogues of amino acids. Observational and randomized controlled trials have shown improvements in biochemical markers of CKD-MBD, including reductions in phosphorus, parathyroid hormone, and fibroblast growth factor-23. However, few studies have assessed changes in bone quantity and quality. Furthermore, studies assessing the effects of high-protein diets on CKD-MBD are scarce. Importantly, very-low- and low-protein diets supplemented with KA provide supplemental calcium in amounts that surpass current dietary recommendations, but to date there are no studies on calcium balance with KA. Current evidence suggests that dietary protein restriction in CKD may slow disease progression, which may subsequently benefit CKD-MBD and bone health outcomes. However, prospective randomized controlled trials assessing the effects of modulating dietary protein and supplementing with KA on all aspects of CKD-MBD and particularly bone health are needed.
引用
收藏
页码:247 / 253
页数:7
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