Comment: The quality of evidence is downgraded by study limitations (open-label studies).
A Cochrane review [Abstract] 1 included 17 studies with a total of 2 996 subjects. Comparing low protein diet to normal diet, there was little or no difference in the numbers of participants who died or reached end-stage renal disease (ESKD) (table T1). A very low protein intake compared with a low protein intake made little or no difference to death. However, it reduced the number who reach ESKD (table T2).
| Outcomes | Relative effect(95% CI) | Risk with control - Normal protein diet | Risk with intervention - Low protein diet (95% CI) | No. of participants(studies) Certainty of the evidence |
|---|---|---|---|---|
| Death (all causes) | RR 0.77(0.51 to 1.18) | 55 per 1 000 | 42 per 1 000(28 to 65) | 1680 (5) Moderate |
| ESKD | RR 1.05(0.73 to 1.53) | 144 per 1 000 | 151 per 1 000(105 to 220) | 1814 (6) Low |
| End or change in GFR | - | The SMD for end or change in GFR was 0.18 lower (0.75 lower to 0.38 higher) with low protein diet compared to normal protein diet | 1680 (8) Very low | |
| Outcomes | Relative effect(95% CI) | Risk with control - Normal or low protein diet | Risk with intervention - Very low protein diet (95% CI) | No. of participants(studies) Certainty of the evidence |
|---|---|---|---|---|
| Death (all causes) | RR 1.26(0.62 to 2.54) | 39 per 1 000 | 49 per 1 000(24 to 99) | 681 (6) Moderate |
| ESKD | RR 0.64(0.49 to 0.85) | 458 per 1 000 | 293 per 1 000(225 to 389) | 1010 (10) Moderate |
| End or change in GFR | - | The SMD for end or change in GFR was 0.12 (0.27 lower to 0.52 higher) with very low protein diet compared to low or normal protein diet | 456 (6) Low | |
Primary/Secondary Keywords