Lokesh N Shah1,2, Matthew B Matheson3, Susan L Furth4,5, George J Schwartz6, Bradley A Warady7,8, Cynthia J Wong9,10. 1. Stanford University School of Medicine, Stanford, CA, USA. Lshah@stanford.edu. 2. Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, CA, USA. Lshah@stanford.edu. 3. Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 4. The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 5. University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. 6. University of Rochester Medical Center, Rochester, NY, USA. 7. University of Missouri Kansas City School of Medicine, Kansas City, MO, USA. 8. Children's Mercy Hospitals and Clinics, Kansas City, MO, USA. 9. Stanford University School of Medicine, Stanford, CA, USA. 10. Lucile Salter Packard Children's Hospital at Stanford, Palo Alto, CA, USA.
Abstract
BACKGROUND: Vegetable or plant-based sources of protein may confer health benefits in children with progressive kidney disease. Our aims were to understand the effect of the proportion of vegetable protein intake on changes in estimated GFR and to understand the effect of the proportion of vegetable protein intake on serum levels of bicarbonate, phosphorus, and potassium. METHODS: Children with baseline eGFR between 30 and 90 mL/min/1.73 m2 were recruited from 59 centers across North America as part of the chronic kidney disease in children (CKiD) study. The percentage of dietary vegetable protein (VP%) was gathered from annual Food Frequency Questionnaires. We performed longitudinal linear mixed models to determine the effect of VP% on eGFR and longitudinal logistic mixed models to determine the effect of VP% on electrolyte balance (potassium, phosphorus, bicarbonate). RESULTS: Two thousand visits from 631 subjects. Across all dichotomized groups of children (sex, African American race, Hispanic ethnicity, glomerular etiology of CKD, hypertension, anemia, hyperkalemia, hyperphosphatemia, acidosis, BMI < 95th percentile), the median VP% was 32-35%. The longitudinal mixed model analysis did not show any effect of VP% on eGFR electrolyte (bicarbonate, phosphorus, and potassium) abnormalities (p > 0.1). CONCLUSIONS: A diverse cohort of children with CKD has a narrow and homogeneous intake of vegetable protein. Due to the low variability of plant-based protein in the cohort, there were no associations between the percentage of plant protein intake and changes in eGFR nor electrolyte balance. A higher resolution version of the Graphical abstract is available as Supplementary information.
BACKGROUND: Vegetable or plant-based sources of protein may confer health benefits in children with progressive kidney disease. Our aims were to understand the effect of the proportion of vegetable protein intake on changes in estimated GFR and to understand the effect of the proportion of vegetable protein intake on serum levels of bicarbonate, phosphorus, and potassium. METHODS: Children with baseline eGFR between 30 and 90 mL/min/1.73 m2 were recruited from 59 centers across North America as part of the chronic kidney disease in children (CKiD) study. The percentage of dietary vegetable protein (VP%) was gathered from annual Food Frequency Questionnaires. We performed longitudinal linear mixed models to determine the effect of VP% on eGFR and longitudinal logistic mixed models to determine the effect of VP% on electrolyte balance (potassium, phosphorus, bicarbonate). RESULTS: Two thousand visits from 631 subjects. Across all dichotomized groups of children (sex, African American race, Hispanic ethnicity, glomerular etiology of CKD, hypertension, anemia, hyperkalemia, hyperphosphatemia, acidosis, BMI < 95th percentile), the median VP% was 32-35%. The longitudinal mixed model analysis did not show any effect of VP% on eGFR electrolyte (bicarbonate, phosphorus, and potassium) abnormalities (p > 0.1). CONCLUSIONS: A diverse cohort of children with CKD has a narrow and homogeneous intake of vegetable protein. Due to the low variability of plant-based protein in the cohort, there were no associations between the percentage of plant protein intake and changes in eGFR nor electrolyte balance. A higher resolution version of the Graphical abstract is available as Supplementary information.
Authors: Juan J Carrero; Ailema González-Ortiz; Carla M Avesani; Stephan J L Bakker; Vincenzo Bellizzi; Philippe Chauveau; Catherine M Clase; Adamasco Cupisti; Angeles Espinosa-Cuevas; Pablo Molina; Karine Moreau; Giorgina B Piccoli; Adrian Post; Siren Sezer; Denis Fouque Journal: Nat Rev Nephrol Date: 2020-06-11 Impact factor: 28.314
Authors: Bradley A Warady; Alison G Abraham; George J Schwartz; Craig S Wong; Alvaro Muñoz; Aisha Betoko; Mark Mitsnefes; Frederick Kaskel; Larry A Greenbaum; Robert H Mak; Joseph Flynn; Marva M Moxey-Mims; Susan Furth Journal: Am J Kidney Dis Date: 2015-03-19 Impact factor: 8.860
Authors: Tanushree Banerjee; Deidra C Crews; Donald E Wesson; Anca M Tilea; Rajiv Saran; Nilka Ríos-Burrows; Desmond E Williams; Neil R Powe Journal: J Am Soc Nephrol Date: 2015-02-12 Impact factor: 10.121
Authors: Jérôme Harambat; Kevin Kunzmann; Karolis Azukaitis; Aysun K Bayazit; Nur Canpolat; Anke Doyon; Ali Duzova; Anna Niemirska; Betul Sözeri; Daniela Thurn-Valsassina; Ali Anarat; Lucie Bessenay; Cengiz Candan; Amira Peco-Antic; Alev Yilmaz; Sibylle Tschumi; Sara Testa; Augustina Jankauskiene; Hakan Erdogan; Alejandra Rosales; Harika Alpay; Francesca Lugani; Klaus Arbeiter; Francesca Mencarelli; Aysel Kiyak; Osman Dönmez; Dorota Drozdz; Anette Melk; Uwe Querfeld; Franz Schaefer Journal: Kidney Int Date: 2017-07-18 Impact factor: 10.612
Authors: Robert N Foley; Allan J Collins; Charles A Herzog; Areef Ishani; Philip A Kalra Journal: J Am Soc Nephrol Date: 2008-11-05 Impact factor: 10.121