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Review
. 2022 Dec 9;16(4):647-661.
doi: 10.1093/ckj/sfac267. eCollection 2023 Apr.

Plant-based diets for CKD patients: fascinating, trendy, but feasible? A green nephrology perspective

Massimo Torreggiani  1 , Antioco Fois  1 , Françoise Lippi  1 , Rossella Attini  2 , Elisa Longhitano  1   3 , Ida Matarazzo  1   4 , Bianca Masturzo  5 , Gianfranca Cabiddu  6 , Elisabetta Versino  7 , Giorgina Barbara Piccoli  1
Affiliations
Review

Plant-based diets for CKD patients: fascinating, trendy, but feasible? A green nephrology perspective

Massimo Torreggiani et al. Clin Kidney J. .

Abstract

Climate change is inducing us to rethink our way of life. There is widespread awareness that we need to adopt environmentally friendly approaches and reduce the amount of waste we generate. In medicine, nephrology was one of the first specialties to adopt a green approach. Plant-based or vegan-vegetarian diets, which are planet-friendly and associated with a reduced carbon footprint, were rapidly acknowledged as a valid method for reducing protein intake in the conservative management of chronic kidney disease (CKD). However, how the transition from an omnivorous to a plant-based diet should be managed is not universally agreed; there is little data in the literature and indications based on randomized trials fail to consider feasibility and patients' preferences. Nonetheless, in some conditions the use of plant-based diets has proved safe and effective. For example, in CKD pregnancies, it has reduced unfavorable maternal and fetal outcomes. This review will present the available evidence on the benefits of plant-based diets in CKD, as well as old and new criticisms of their use, including emerging issues, such as contaminants, additives and pesticides, from a green nephrology perspective.

Keywords: additives; carbon footprint; low-protein diet; pesticides; pregnancy.

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Conflict of interest statement

G.B.P. received a research grant and consultant fees from Fresenius Kabi. She is also member of the CKJ Editorial Board. All the other authors declare there are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Examples of early diets: (A) an adaptation of the Giovannetti diet in use at the Royal Infirmary of Manchester in 1965 (from reference [45]); (B) a dietary prescription at the Royal Infirmary of Edinburgh in the 1960s (from http://edren.org/ren/unit/history/the-diet-for-patients-on-haemodialysis/?print = print).
Figure 2:
Figure 2:
Stepwise dietary approach. Modified from reference [105].
Figure 3:
Figure 3:
Benefits of plant-based diets.
See this image and copyright information in PMC

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