NEW DELHI: Restricting protein intake among adult chronic kidney disease (CKD) patients, irrespective of having diabetes or not, may not work for Indians, according to the latest study, which also claimed that a vegetarian diet is more effective than animal protein.
Most guidelines for CKD management recommend protein restriction, which the study, published in Science Direct, said is controversial. The study aimed at reaching a “consensus on the topic, especially among Indian adults.”
Before recommending guideline-directed protein restriction, assessing the nutritional status of people with CKD is essential, particularly in countries like India, where the average daily protein intake is poor, said the study’s findings.
“The prescribed diet, including the quantity and quality of proteins, should be tailored to the person’s habits, tastes, and needs,” said the study. The study concluded that low protein consumption across all sectors, regions and income groups in India must be factored in before routinely recommending a low-protein diet to all Indian adults with CKD.
“There is a close relationship between dietary protein intake and its effect on renal function. Evidence suggests that high protein intake causes deterioration of renal function in people with CKD,” the report added. In India, the prevalence of CKD is very high, around 13 % to 17 %. The commonest cause of developing CKD is hypertension and diabetes.
The study also concluded that a vegetarian diet could be a better option for such patients. Contrary to traditional belief, increasing evidence supports the safety and possible superiority of a plant-based or vegetarian diet over a diet based on animal proteins for patients with CKD. “This is particularly relevant for India, where almost half the population prefers a vegetarian diet or a predominantly a plant-based diet with very little animal protein,” said the study.
The study acknowledges a close relationship between dietary protein intake and its effect in renal function. “Evidence suggests that high protein intake causes deterioration of renal function in people with CKD.”
Dr Upal Sengupta, Nephrologist, Fortis, Kolkata, and one of the authors of the study, said, “Protein restriction has been in vogue with variable amounts of evidence that protein restriction in some way is going to help prevent the progression of chronic kidney disease.”
A low-protein diet in adults with stages 3-5 CKD who are not on haemodialysis reduces the severity of uremic symptoms, thereby delaying the initiation of dialysis, he added. Uremic symptoms happen due to kidney failure, nausea, loss of appetite, and lethargy.
“In our scenario, we see a large number of poor patients who don’t get a good amount of protein. Further restriction in protein will make them malnourished and worsen their condition if we start dialysis,” Sengupta said. However, he cautioned that they certainly should not take Keto diet.