Low protein diets and low phosphate diets are often considered as solutions for slowing down CKD progression. Moreover, plant-based diets are superior to traditional animal protein diets for prevention and treatment of diabetic kidney disease. Nowadays, there are only short-term studies about the effects of vegetarian diet in CKD patients. Therefore, further long-term studies are required to critically examine the effects of substitution of plant protein for animal protein in the diets on the renal function of CKD patients.

Our objective was to investigate potential impact on renal progression of different dietary patterns.

During 2006 to 2015, 914 CKD patients aged >20 had been recruited from nephrology clinics and referred to registered dietitians for one-year low protein diet
education. Since there is a big difference in numbers of vegans (n=22, 10 males and 12 females; mean age: 75±9.5) and omnivores (n=892), only 88 omnivores (sex-, age-, CKD
stage-, and primary disease-matched) were chosen for the following study. Participants’ dietary intakes were assessed with diet-history interview, 3-day dietary records and a 24-
hour dietary recall four times during one-year interval, and collected eGFR, BMI and serum albumin.

There was no significant difference between omnivores and vegan groups at baseline. After three month, there was significant difference between omnivores and vegan groups in eGFR decline (p=0.041). However, there was no significant difference after six month and one year. The omnivores group’s overall mean eGFR change was -1.60 ml/mim per 1.73 m2 (p=0.038). The vegan group’s overall mean eGFR change was -3.36 ml/mim per 1.73 m2 (p=0.036).

Plant-based protein as compared with animal-based protein, may have less adverse impact on metabolic risk factors in CKD. There were no statistically significant associations of plant-based diet and renal functions. The reasons might be the plant protein quality and food additives of vegan diet in Taiwan.