Protein restriction for children with chronic kidney disease

Chaturvedi S, Jones C

Published Online:

October 7, 2009

Low protein diet can delay kidney failure in adults with kidney disease, however a diet low in protein in children raises concern of poor growth. The review identified 2 studies (250 children) in children with kidney disease and found that a low protein diet does not delay progression to kidney failure (end-stage kidney disease). There remains some concern regarding adverse effect on growth.

Abstract (click to read)

Background:

Protein restriction has been prescribed for some time for patients with chronic kidney disease (CKD). The effect of a low protein diet on delaying the progression to end-stage kidney disease (ESKD) in children and its impact on growth and nutrition remains unresolved.

Objectives:

To determine the efficacy of protein restricted diet in delaying the start of maintenance dialysis and maintaining nutrition in children.

Search strategy:

Cochrane Renal group trials register, the Cochrane Central register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, reference lists of nephrology textbooks, review articles and relevant studies.

Selection criteria:

Randomised control trials (RCTs) comparing un-restricted protein diet versus a protein restricted diet (to safe amounts recommended by WHO), with follow-up period of at least six months were included.

Data collection and analysis:

Two authors independently selected studies. Statistical analysis were performed using the random effects model. For dichotomous outcome results are expressed as risk ratio (RR) with 95% confidence intervals (CI). Where continuous scales of measurement are used to assess the effects of treatment, the mean difference (MD) was used.

Main results:

Two studies (250 children) were identified, 124 received a protein restricted diet and 126 a control diet. No significant differences was found in the number of renal deaths (RR 1.12, 95% CI 0.54 to 2.33), progression of kidney disease (creatinine clearance at two years: MD 1.47, 95% CI -1.19 to 4.14) or growth (weight - MD -0.13, 95% CI -1.10 to 0.84; height - MD -1.99, 95% CI -4.84 to 0.86).

Authors' conclusions:

Reducing protein intake does not appear to have significant impact in delaying the progression to ESKD in children.

This record should be cited as:

Chaturvedi S, Jones C. Protein restriction for children with chronic kidney disease. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006863. DOI: 10.1002/14651858.CD006863

Assessed as up to date:

August 10, 2007

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Primary Review Group:

Renal Group

Health topics:

Kidney disease > Chronic kidney disease > Nutrition & lifestyle

Complementary & alternative medicine > Kidney disease > Chronic kidney disease

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Protein restriction for children with chronic kidney disease

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