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.
閱讀完整摘要
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.
目的
To determine the efficacy of protein restricted diet in delaying the start of maintenance dialysis and maintaining nutrition in children.
搜尋策略
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.
選擇標準
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.
資料收集與分析
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.
主要結果
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).
作者結論
Reducing protein intake does not appear to have significant impact in delaying the progression to ESKD in children.
