Soy protein in low protein diets increases cardioprotection in patients with CKD
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Soy protein plus ketoanalogues of essential amino acids produced a larger effect on nephroprotection and cardioprotection in patients with stages 3b to 4 chronic kidney disease than a conventional low protein diet, researchers reported.
“Based on our results, inclusion of soy protein in the diet of patients with chronic kidney disease promotes to maintenance muscle mass, slows down estimated glomerular filtration rate decrease and diminishes left ventricle hypertrophy, augmentation index, urea, cholesterol and phosphorus serum levels,” Ludmila Yu Milovanova, PhD, MD, professor at Sechenov First Moscow State Medical University, and colleagues wrote in Journal of Renal Nutrition.
In a prospective, randomized-controlled clinical study, researchers examined 85 patients aged 18 to65 years with CKD stages 3b to 4 who were compliant with a low protein diet in combination with ketoanalogues of essential amino acids (KA) to compare the contribution of a conventional low protein diet vs. one with primarily soy protein to nephroprotection and cardioprotection in CKD.
In a 12-month period, researchers monitored 43 patients who consumed a low protein diet with soy protein and KA, while the other 42 patients consumed a conventional low protein diet with animal protein and KA.
Researchers measured BMI, total fat and muscle mass using bioimpedance analysis to gauge nutritional status. Measurements also included eGFR, levels of calcium, phosphorous and PTH in serum, central systolic blood pressure, valve calcification, left ventricle hypertrophy and augmentation index.
Milovanova and colleagues found that substituting soy protein into a low protein diet for patients with CKD delayed decreases in eGFR (–5.9% vs. –11.3%; P = .048), as well as lean body mass in both men (0.9% vs. –11.2%; P = .017) and women (–1.8% vs. –10.3%; P = .024). Meanwhile, soy protein diets also delayed increases in left ventricle hypertrophy (4.7% vs. 12.3%; P = .042), central systolic blood pressure (2.6% vs. 13%; P = .021), augmentation index (7.6% vs. 23.3%; P = .010), phosphorus (–10.3% vs. 13%; P = .029), cholesterol (–10.7% vs. –3.4%; P = .047), urea (6.3% vs. 19.6%; P = .035) and serum levels.
“[Soy protein] may potentially substitute animal protein in patients with pre-dialysis CKD and improve nephro[protective] and cardioprotective potential of low protein diets,” Milovanova and colleagues wrote.
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