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Meta-Analysis
. 2015 Dec 22;10(12):e0144442.
doi: 10.1371/journal.pone.0144442. eCollection 2015.

Beneficial Effects of Caloric Restriction on Chronic Kidney Disease in Rodent Models: A Meta-Analysis and Systematic Review

Xiao-Meng Xu  1   2 , Guang-Yan Cai  1 , Ru Bu  1 , Wen-Juan Wang  1   2 , Xue-Yuan Bai  1 , Xue-Feng Sun  1 , Xiang-Mei Chen  1
Affiliations
Meta-Analysis

Beneficial Effects of Caloric Restriction on Chronic Kidney Disease in Rodent Models: A Meta-Analysis and Systematic Review

Xiao-Meng Xu et al. PLoS One. .

Abstract

Background: Numerous studies have demonstrated the life-extending effect of caloric restriction. It is generally accepted that caloric restriction has health benefits, such as prolonging lifespan and delaying the onset and progression of CKD in various species, especially in rodent models. Although many studies have tested the efficacy of caloric restriction, no complete quantitative analysis of the potential beneficial effects of reducing caloric intake on the development and progression of CKD has been published.

Methods: All studies regarding the relationship between caloric restriction and chronic kidney diseases were searched in electronic databases, including PubMed/MEDLINE, EMBASE, Science Citation Index (SCI), OVID evidence-based medicine, Chinese Bio-medical Literature and Chinese science and technology periodicals (CNKI, VIP, and Wan Fang). The pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated by using fixed- or random-effects models.

Results: The data from 27 of all the studies mentioned above was used in the Meta analysis. Through the meta-analysis, we found that the parameter of blood urea nitrogen, serum creatinine and urinary protein levels of the AL group was significant higher than that of the CR group, which are 4.11 mg/dl, 0.08mg/dl and 33.20mg/kg/24h, respectively. The incidence of the nephropathy in the caloric restriction (CR) group was significantly lower than that in the ad libitum-fed (AL) group. We further introduced the subgroup analysis and found that the effect of caloric restriction on the occurrence of kidney disease was only significant with prolonged intervention; the beneficial effects of CR on the 60%-caloric-restriction group were greater than on the less-than-60%-caloric-restriction group, and caloric restriction did not show obvious protective effects in genetically modified strains. Moreover, survival rate of the caloric restriction group is much higher than that of the ad libitum-fed (AL) group.

Conclusions: Our findings demonstrate for the first time that compared with the AL group, the caloric restriction indeed decreased urea nitrogen, creatinine, urine protein, incidence of kidney diseases and increased the survival rate on 700~800 days.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Summary of the process for identifying candidate studies.
Fig 2
Fig 2. Forest plot comparing the blood urea nitrogen of the ad libitum—fed and caloric restriction groups.
■, WMD of each study; horizontal lines represent the 95% CIs for the data; ◆, combined overall effect.
Fig 3
Fig 3. Forest plot comparing the serum creatinine levels of the ad libitum—fed and caloric restriction groups.
■, WMD of each study; horizontal lines represent the 95% CIs for the data; ◆, combined overall effect.
Fig 4
Fig 4. Forest plot comparing the urinary protein levels of the ad libitum—fed and caloric restriction groups.
■, WMD of each study; horizontal lines represent the 95% CIs for the data; ◆, combined overall effect.
Fig 5
Fig 5. Forest plot comparing the incidence of nephropathy in the ad libitum—fed group and the caloric restriction group.
■, OR (odds ratios) of each study; horizontal lines represent the 95% CIs for the data; ◆, combined overall effect. (A) The effectiveness of the caloric restriction on the incidence of nephropathy. (B) Subgroup analysis based on the intervention duration. (C) Subgroup analysis based on the percentage of caloric restriction. (D) Subgroup analysis based on whether genetically modified model or not.
Fig 6
Fig 6. Forest plot comparing the survival rates of the ad libitum—fed and caloric restriction groups.
■, OR (odds ratios) of each study; horizontal lines represent the 95% CIs for the data; ◆, combined overall effect.
See this image and copyright information in PMC

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