{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T10:40:33Z","timestamp":1776940833909,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,11]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>A 69-year-old man with type 2 diabetes, hypertension and stage 3 chronic kidney disease (CKD), hyperphosphataemia and borderline hyperkalaemia presented to an office visit interested in changing his diet to improve his medical conditions. He adopted a strict whole-foods, plant-based diet, without calorie or portion restriction or mandated exercise, and rapidly reduced his insulin requirements by &gt;50%, and subsequently saw improvements in weight, blood pressure and cholesterol. His estimated glomerular filtration rate (eGFR) increased from 45 to 74\u2009mL\/min after 4.5 months on the diet and his microalbumin\/creatinine ratio decreased from 414.3 to 26.8\u2009mg\/g. His phosphorus level returned to the normal range. For individuals with CKD, especially those with obesity, hypertension, or diabetes, a strict, ad libitum whole-food, plant-based diet may confer significant benefit, although one must consider potential limitations of a creatinine-based GFR equation in the face of significant weight loss.<\/jats:p>","DOI":"10.1136\/bcr-2019-232080","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T04:55:20Z","timestamp":1577163320000},"page":"e232080","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Plant-based dietary approach to stage 3 chronic kidney disease with hyperphosphataemia"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4449-8229","authenticated-orcid":false,"given":"Thomas M","family":"Campbell","sequence":"first","affiliation":[{"name":"Family Medicine, University of Rochester Medical Center, Rochester, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott E","family":"Liebman","sequence":"additional","affiliation":[{"name":"Nephrology, University of Rochester Medical Center, Rochester, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"2025082802114340000_12.12.e232080.1","unstructured":"CDC: Centers for Disease Control and Prevention . Chronic Kidney Disease (CKD) Surveillance System - United States. Available: https:\/\/nccd.cdc.gov\/CKD\/default.aspx"},{"key":"2025082802114340000_12.12.e232080.2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1053\/j.jrn.2017.01.001","article-title":"Obesity and kidney disease: hidden consequences of the epidemic","volume":"27","author":"Kovesdy","year":"2017","journal-title":"J Ren Nutr"},{"key":"2025082802114340000_12.12.e232080.3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/MOP.0000000000000586","article-title":"Obesity and chronic kidney disease","volume":"30","author":"Nehus","year":"2018","journal-title":"Curr Opin Pediatr"},{"key":"2025082802114340000_12.12.e232080.4","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"The Lancet"},{"key":"2025082802114340000_12.12.e232080.5","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases . Eating right for chronic kidney disease. NIH, 2016."},{"key":"2025082802114340000_12.12.e232080.6","unstructured":"National Kidney Foundation . Nutrition and kidney disease, stages 1-4. Available: https:\/\/www.kidney.org\/nutrition\/Kidney-Disease-Stages-1-4"},{"key":"2025082802114340000_12.12.e232080.7","doi-asserted-by":"publisher","DOI":"10.2337\/ds16-0084"},{"key":"2025082802114340000_12.12.e232080.8","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.73"},{"key":"2025082802114340000_12.12.e232080.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.23.2001"},{"key":"2025082802114340000_12.12.e232080.10","first-page":"356","article-title":"A way to reverse CAD?","volume":"63","author":"Esselstyn","year":"2014","journal-title":"J Fam Pract"},{"key":"2025082802114340000_12.12.e232080.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00290-8"},{"key":"2025082802114340000_12.12.e232080.12","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19840066"},{"key":"2025082802114340000_12.12.e232080.13","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1080\/07315724.1995.10718541","article-title":"Rapid reduction of serum cholesterol and blood pressure by a twelve-day, very low fat, strictly vegetarian diet","volume":"14","author":"McDougall","year":"1995","journal-title":"J Am Coll Nutr"},{"key":"2025082802114340000_12.12.e232080.14","doi-asserted-by":"crossref","DOI":"10.1038\/nutd.2017.3","article-title":"The broad study: a randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes","volume":"7","author":"Wright","year":"2017","journal-title":"Nutr Diabetes"},{"key":"2025082802114340000_12.12.e232080.15","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.26736H"},{"key":"2025082802114340000_12.12.e232080.16","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.6.3.268"},{"key":"2025082802114340000_12.12.e232080.17","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"2025082802114340000_12.12.e232080.18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.22230\/ijdrp.2019v1n1a47","article-title":"Six-Week raw, vegan nutrition protocol rapidly reverses lupus nephritis: a case series","volume":"1","author":"Goldner","year":"2019","journal-title":"International Journal of Disease Reversal and Prevention"},{"key":"2025082802114340000_12.12.e232080.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(95)00219-7"},{"key":"2025082802114340000_12.12.e232080.20","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014040332"},{"key":"2025082802114340000_12.12.e232080.21","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.2215\/CJN.01080114","article-title":"The association between a Mediterranean-Style diet and kidney function in the Northern Manhattan study cohort","volume":"9","author":"Khatri","year":"2014","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.22","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.83"},{"key":"2025082802114340000_12.12.e232080.23","doi-asserted-by":"crossref","first-page":"682","DOI":"10.2215\/CJN.12391018","article-title":"Plant-Based diets and incident CKD and kidney function","volume":"14","author":"Kim","year":"2019","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.24","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1053\/j.ajkd.2015.10.018","article-title":"The associations of plant protein intake with all-cause mortality in CKD","volume":"67","author":"Chen","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2025082802114340000_12.12.e232080.25","doi-asserted-by":"crossref","first-page":"272","DOI":"10.2215\/CJN.06190616","article-title":"Healthy dietary patterns and risk of mortality and ESRD in CKD: a meta-analysis of cohort studies","volume":"12","author":"Kelly","year":"2017","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.26","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.6.659"},{"key":"2025082802114340000_12.12.e232080.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"2025082802114340000_12.12.e232080.28","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2215\/CJN.08960718","article-title":"Plant-Based diets in CKD","volume":"14","author":"Clegg","year":"2019","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.29","doi-asserted-by":"crossref","first-page":"257","DOI":"10.2215\/CJN.05040610","article-title":"Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease","volume":"6","author":"Moe","year":"2011","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.30","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfw046"},{"key":"2025082802114340000_12.12.e232080.31","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft302"},{"key":"2025082802114340000_12.12.e232080.32","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1053\/j.ajkd.2016.09.020","article-title":"Estimated GFR before and after bariatric surgery in CKD","volume":"69","author":"Imam","year":"2017","journal-title":"American Journal of Kidney Diseases"},{"key":"2025082802114340000_12.12.e232080.33","doi-asserted-by":"crossref","first-page":"348","DOI":"10.2215\/CJN.02870707","article-title":"Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C","volume":"3","author":"Baxmann","year":"2008","journal-title":"CJASN"},{"key":"2025082802114340000_12.12.e232080.34","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12143"},{"key":"2025082802114340000_12.12.e232080.35","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-017-0474-0","article-title":"Effect of large weight reductions on measured and estimated kidney function","volume":"18","author":"von Scholten","year":"2017","journal-title":"BMC Nephrol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:11:52Z","timestamp":1756372312000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,23]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-232080"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232080","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}