A PLANT-BASED low-protein diet may be a feasible and effective strategy for reducing complications and preventing malnutrition–inflammation complex syndrome (MICS) in adults with chronic kidney disease (CKD), according to findings from a single-centre preliminary study.
Malnutrition–Inflammation Complex Syndrome in CKD
CKD represents a growing global public health challenge, and dietary protein restriction has long been recognised as a cornerstone of conservative disease management. Lower protein intake can reduce uremic toxin production, improve renal haemodynamics, and delay the need for dialysis. However, concerns remain regarding the risk of malnutrition, particularly in patients with advanced disease. MICS, characterised by the coexistence of protein–energy wasting and chronic inflammation, is a recognised non-traditional cardiovascular risk factor in CKD and is associated with poor clinical outcomes.
While vegetarian and plant-based diets have been shown to improve cardiovascular health and reduce inflammation in CKD, evidence regarding their role in preventing MICS is limited. This study aimed to assess the feasibility and efficacy of a plant-based diet in adults with CKD stages 3–5.
Adult patients with moderate-to-advanced CKD were retrospectively recruited and assessed at baseline and after six months of dietary intervention. Evaluations included biochemical parameters, anthropometric measurements, body composition analysis, muscle strength assessment, and pharmacological treatment review.
After six months, participants demonstrated significant improvements in several clinical parameters. Measures of kidney function, lipid profile, and glycaemic control improved, alongside increases in vitamin D levels and reductions in plasma fibrinogen, a marker of inflammation. Favourable changes were also observed in anthropometric indices, body composition, and muscle strength, suggesting preserved or improved nutritional status.
Importantly, plasma albumin levels remained stable throughout the intervention, indicating that protein restriction within a plant-based framework did not compromise key markers of nutrition. In line with recent literature, concerns regarding hyperkalaemia associated with plant-based diets in CKD were not supported by the study findings.
Clinical Implications of Plant-Based Nutrition in CKD Care
The authors conclude that a plant-based low-protein diet appears both safe and effective in reducing CKD-related metabolic and inflammatory complications, while potentially preventing the development of MICS. Although limited by its single-centre design and small sample size, the study provides encouraging preliminary evidence supporting the role of dietary protein quality, not just quantity, in CKD management.
Further prospective, larger-scale studies are needed to confirm these findings and clarify the long-term clinical impact of plant-based nutritional strategies in CKD care.
Reference
Amicone M et al. Plant-based low-protein diet for preventing malnutrition‒inflammation complex syndrome in adults with CKD: a single-centre preliminary experience. BMC Nephrol. 2026;doi: 10.1186/s12882-025-04729-5
