title: Stirring the Pot: Can Dietary Modification Alleviate the Burden of CKD?
abstract: Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD)-related death and disability. CKD is largely a progressive disease; however, it is increasingly appreciated that hallmarks of chronic kidney disease such as albuminuria can regress over time. The factors driving albuminuria resolution remain elusive. Since albuminuria is a strong risk factor for GFR loss, modifiable lifestyle factors that lead to an improvement in albuminuria would likely reduce the burden of CKD in high-risk individuals, such as patients with diabetes. Dietary therapy such as protein and sodium restriction has historically been used in the management of CKD. Evidence is emerging to indicate that other nutrients may influence kidney health, either through metabolic or haemodynamic pathways or via the modification of gut homeostasis. This review focuses on the role of diet in the pathogenesis and progression of CKD and discusses the latest findings related to the mechanisms of diet-induced kidney disease. It is possible that optimizing diet quality or restricting dietary intake could be harnessed as an adjunct therapy for CKD prevention or progression in susceptible individuals, thereby reducing the burden of CKD.
authors.affiliation: Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia. Matthew.Snelson@bakeridi.edu.au.
authors.forename: Matthew
authors.initials: M
authors.lastname: Snelson
authors.affiliation: Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia. rachel.clarke@bakeridi.edu.au.|Department of Physiology, Monash University, Clayton 3800, Australia. rachel.clarke@bakeridi.edu.au.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Clarke
authors.affiliation: Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia. Melinda.Coughlan@monash.edu.|Department of Diabetes, Central Clinical School, Monash University, Alfred Medical Research and Education Precinct, Melbourne 3004, Australia. Melinda.Coughlan@monash.edu.
authors.forename: Melinda T
authors.initials: MT
authors.lastname: Coughlan
mesh_terms: D000818:Animals; D003131:Combined Modality Therapy / Q000009:adverse effects; D017281:Cost of Illness; D000072001:Diet, Healthy; D018753:Diet, Protein-Restricted / Q000009:adverse effects; D004039:Diet, Sodium-Restricted / Q000009:adverse effects; D019587:Dietary Supplements; D018450:Disease Progression; D019317:Evidence-Based Medicine; D000070497:Healthy Lifestyle; D006801:Humans; D007668:Kidney / Q000502:physiology* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D012307:Risk Factors
keywords: advanced glycation end products; albuminuria; cardiovascular disease; chronic kidney disease; diabetes; diet; inflammation