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CKD: Protein Type (Plant vs Animal) (2018)

Intervention
What is the effect of protein type on total and LDL cholesterol and triglyceride levels in adults with CKD 4-5D?
- Conclusion
  Consumption of vegetable vs animal protein did not affect total or low-density lipoprotein (LDL) cholesterol or triglyceride levels in hemodialysis, peritoneal dialysis or Stage 4 CKD patients.
- 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 type on total and LDL cholesterol and triglyceride levels in adults with CKD 4-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on HDL cholesterol levels in adults with CKD 4-5D?
- Conclusion
  Consumption of vegetable vs animal protein did not affect high-density lipoprotein (HDL) levels in hemodialysis, peritoneal dialysis or Stage 4 CKD patients.
- 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 type on HDL cholesterol levels in adults with CKD 4-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on hemoglobin levels in adults with CKD 4?
- Conclusion
  Soroka, et al. (positive-quality Randomized Crossover) found no significant difference in hemoglobin levels between vegetarian low-protein diet, animal-based low-protein diet, or prestudy diet in patients with Stage 4 CKD, non-dialyzed.
- 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 type on hemoglobin levels in adults with CKD 4?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Soroka N, Silverberg D, Greemland M, Birk Y, Blum M, Peer G, Iaina A. Comparison of a vegetable-based (soya) and an animal-based low-protein diet in predialysis chronic renal failure patients. Nephron 1998; 79:173-80
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on electrolyte levels in adults with CKD 3-4?
- Conclusion
  In patients with Stage 4 CKD, there was no effect of vegetarian low-protein diet (VPD) vs animal-based low-protein diet (ADP) or pre-study diet on plasma on serum or urinary calcium levels. A VPD for seven days to six months did not affect serum/plasma phosphorus levels in patients with Stages 3-4, but did decrease 24-hour urinary phosphate levels by a mean difference of -126.6 (-200.4, -52.7) mg.
- 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 type on electrolyte levels in adults with CKD 3-4?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on inflammatory markers in adults with CKD 5D on hemodialysis?
- Conclusion
  There was no effect of soy vs. milk protein on inflammatory markers in patients on hemodialysis.
- 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 type on inflammatory markers in adults with CKD 5D on hemodialysis?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on pre-albumin levels and PCR in adults with CKD 4-5D?
- Conclusion
  Soy protein did not affect pre-albumin levels after eight weeks compared to a control group in patients on hemodialysis, but evidence was limited. Vegetable protein may be associated with a decrease in protein catabolic rate (PCR) after six months in non-dialyzed, Stage 4 patients, but evidence was limited.
- 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 type on pre-albumin levels and PCR in adults with CKD 4-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018
What is the effect of protein type on albumin levels in adults with CKD 1-5D?
- Conclusion
  Protein type did not affect albumin levels.
- 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 type on albumin levels in adults with CKD 1-5D?
- Search Plan and Results: CKD Macronutrients: Dietary Protein 2018