PP134 - IMPACT OF LOW-PROTEIN DIETARY PATTERNS WITH EMPHASIS ON PLANT-BASED FOODS ON THE PROGRESSION OF CHRONIC KIDNEY DISEASE PRIOR TO END-STAGE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

PP134

IMPACT OF LOW-PROTEIN DIETARY PATTERNS WITH EMPHASIS ON PLANT-BASED FOODS ON THE PROGRESSION OF CHRONIC KIDNEY DISEASE PRIOR TO END-STAGE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

F. Skalidou^1,*, S. Chaloulakou², E. Magriplis³, Z. Tsimtsiou¹, M. Chourdakis¹, K.-A. Poulia³

¹Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece, ²Charité-Universitätsmedizin Berlin, Berlin, Germany, ³Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece

Rationale: While low-protein diets have been shown to slow Chronic Kidney Disease (CKD) progression, research interest has recently focused on plant-based nutritional approaches. This study aimed to evaluate the impact of plant-based low-protein diets on renal function and clinical outcomes in patients with CKD pre-dialysis.

Methods: This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with PRISMA guidelines. A systematic literature search in PubMed/Medline, Cochrane Library, and Scopus databases up to July 2025 identified eligible studies [patients ≥18 years old, with CKD stages 1-4, estimated glomerular filtration rate (eGFR)>15 mL/min/1.73 m²]. Primary endpoints were changes in eGFR, serum creatinine (SCr), blood urea nitrogen (BUN), and the time required for initiation of renal replacement therapy (RRT). Secondary outcomes included urinary protein (UProt), blood pressure (BP), and serum electrolytes.

Results: Eleven RCTs (n=889) were included. The meta-analysis indicated better preservation of eGFR in the intervention group, by 1.92 mL/min/1.73 m² [95% CI (0.88, 2.96), p<0.001]. Two studies demonstrated a significant delay in RRT initiation, with lower rates in the intervention group (11% vs 30% and 4% vs 27%). A decreased phosphate by 0.71 mg/dl [95% CI (-1.22, -0.2), p=0.01] and an increased potassium by 0.26 mg/dl [95% CI (0.18, 0.33), p<0.001] were found in the plant-based group.

Conclusion: A plant-based low-protein diet appears to be a beneficial approach for patients with CKD pre-dialysis. However, the modest increase in serum potassium indicates the need for further research to confirm clinical benefits.

Disclosure of Interest: None declared