CKD: Protein Restriction: Low Protein Diet (2018)

Intervention
What is the effect of protein restriction with a low protein diet on survival/mortality in adults with CKD 1-5D and post-transplant?
- Conclusion
  Research reports a beneficial effect of protein restriction (0.55-0.6 g/kg/d) on end stage renal disease (ESRD)/death in adults with CKD.
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on survival/mortality in adults with CKD 1-5D and post-transplant?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on quality of life in adults with CKD 3-5?
- Conclusion
  In adults with CKD, quality of life scores for general health and physical status improved significantly in adults with CKD Stages 3 to 5 after protein restriction without supplementation (0.6 g/kg) based on findings from only one study.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on quality of life in adults with CKD 3-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on LDL cholesterol levels in adults with CKD 1-5?
- Conclusion
  Based on a single study, protein restriction (0.55 g protein/kg/d) without supplementation did not have a clear effect on LDL-C in adults with CKD Stages 1 to 5.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on LDL cholesterol levels in adults with CKD 1-5?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on blood pressure in adults with CKD 1-5?
- Conclusion
  Research reported no effect of protein restriction with a low protein diet (0.6 g protein/kg/d) on blood pressure in adults with CKD Stages 1 to 5.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on blood pressure in adults with CKD 1-5?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on eGFR in adults with CKD 1-5?
- Conclusion
  Research reports no significant effect of dietary protein restriction (0.55-0.6 g/kg/d) without any supplementation on eGFR in adults with adults with CKD Stages 1 to 5.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on eGFR in adults with CKD 1-5?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on phosphate levels in adults with CKD 1-5D?
- Conclusion
  The effect of protein restriction without any supplementation (0.4 to 0.55 g) on phosphate levels in adults with CKD is not clear.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on phosphate levels in adults with CKD 1-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on anthropometric measures in adults with CKD 1-3?
- Conclusion
  Protein restriction without supplementation has an unclear effect on anthropometric measures in non-dialyzed CKD adults, Stages 1-3.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on anthropometric measures in adults with CKD 1-3?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Jesudason D, Pedersen E, Clifton P. Weight-loss diets in people with type 2 diabetes and renal disease: a randomized controlled trial of the effect of different dietary protein amounts. The American Journal of Clinical Nutrition 2013; 98:494-501
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on albumin levels in adults with CKD 4-5D?
- Conclusion
  Protein restriction (0.55-0.9 g protein/kg/d) without supplementation has no effect on albumin levels in adults with CKD Stages 4-5 and on hemodialysis.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on albumin levels in adults with CKD 4-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein restriction with a low protein diet on dietary intake in adults with CKD, non-dialyzed?
- Conclusion
  In patients with CKD who were primarily non-dialyzed, protein intake was lower in subjects assigned to low-protein diet and subjects were compliant in following a low-protein diet (0.6 g/kg).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What is the effect of protein restriction with a low protein diet on dietary intake in adults with CKD, non-dialyzed?