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Medical Nutrition Therapy Using Plant-focused Low-protein Meal Plans for Management of Chronic Kidney Disease in Diabetes by Kamyar Kalantar-Zadeh; Connie M. Rhee; Shivam Joshi; Amanda Brown-Tortorici; Holly M. Kramer is a Medicine article available to read on EtoBox.

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## Purpose of review Nearly half of all Americans with chronic kidney disease (CKD) also have type-2-diabetes (T2D). Whereas traditional and emerging pharmacotherapies are increasingly frequently used for the management of CKD in diabetes (CKD/DM), the role of integrated or multimodal interventions including the potentially synergistic and additive effect of diet and lifestyle modifications in addition to pharmacotherapy has not been well examined, in sharp contrast to the well-known integrated approaches to heart disease. ## Recent findings Low-carbohydrate low-fat diets are often recommended in T2D, whereas low-protein diets (LPD) are recommended by guidelines for nondiabetic CKD with increasing emphasis on plant-based protein sources. High-protein diets with greater animal protein lead to glomerular hyperfiltration, especially in patients with T2D, and faster decline in renal function. Guidelines provide differing recommendations regarding the amount (low vs high) and source (plant vs animal) of dietary protein intake (DPI) in CKD/DM. Some such as KDIGO recommend 0.8 g/kg/day based on insufficient evidence for DPI restriction in CKD/DM, whereas KDOQI and ISRNM recommend a DPI of

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Author

Kamyar Kalantar-Zadeh; Connie M. Rhee; Shivam Joshi; Amanda Brown-Tortorici; Holly M. Kramer

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

2021

Language

EN

Field

Medicine (Health Sciences)