{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:29:11Z","timestamp":1791851351805,"version":"4.3.4"},"reference-count":50,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T00:00:00Z","timestamp":1665273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Reducing protein intake in patients with chronic kidney disease (CKD) limits glomerular stress induced by hyperfiltration and can prevent the progression of kidney disease; data in pregnancy are limited. The aim of this study is to analyze the results obtained in CKD patients who followed a plant-based moderately protein-restricted diet during pregnancy in comparison with a propensity-score-matched cohort of CKD pregnancies on unrestricted diets. A total of 52 CKD pregnancies followed up with a protein-restricted plant-based diet (Torino, Italy) were matched with a propensity score based on kidney function and proteinuria with CKD pregnancies with unrestricted protein intake (Cagliari Italy). Outcomes included preterm (&lt;37 weeks) and very preterm (&lt;34 weeks) delivery and giving birth to a small-for-gestational-age baby. The median age in our cohort was 34 years, 63.46% of women were primiparous, and the median body mass index (BMI) was 23.15 kg\/m2 with 13.46% of obese subjects. No statistical differences were found between women on a plant-based diet and women who were not in terms of age, parity, BMI, obesity, CKD stage, timing of referral, or cause of CKD. No differences were found between the two groups regarding the week of delivery. However, the combined negative outcome (birth before 37 completed gestational weeks or birth-weight centile &lt;10) occurred less frequently in women following the diet than in women in the control group (61.54% versus 80.77%; p = 0.03). The lower risk was confirmed in a multivariable analysis adjusted for renal function and proteinuria (OR: 0.260 [Q1:0.093\u2013Q3:0.724]; p = 0.010), in which the increase in proteinuria from the first to the last check-up before delivery was lower in patients on plant-based diets (median from 0.80 to 1.87 g\/24 h; p: ns) than in controls (0.63 to 2.39 g\/24 h p &lt; 0.0001). Plant-based, moderately protein-restricted diets in pregnancy in patients with CKD are associated with a lower risk of preterm delivery and small-for-gestational-age babies; the effect may be mediated by better stabilization of proteinuria.<\/jats:p>","DOI":"10.3390\/nu14194203","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T01:21:07Z","timestamp":1665364867000},"page":"4203","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Plant-Based Diets Improve Maternal\u2013Fetal Outcomes in CKD Pregnancies"],"prefix":"10.3390","volume":"14","author":[{"given":"Rossella","family":"Attini","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Chatrenet","sequence":"additional","affiliation":[{"name":"N\u00e9phrologie et Dialyse, Centre Hospitalier Le Mans, 72037 Le Mans, France"},{"name":"Laboratory \u201cMovement, Interactions, Performance\u201d (EA 4334), Le Mans University, 72000 Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5222-4431","authenticated-orcid":false,"given":"Elisa","family":"Longhitano","sequence":"additional","affiliation":[{"name":"N\u00e9phrologie et Dialyse, Centre Hospitalier Le Mans, 72037 Le Mans, France"},{"name":"Department of Clinical and Experimental Medicine, Unit of Nephrology and Dialysis, A.O.U. \u201cG. Martino\u201d, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Casula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Tomasi Cont","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Zaccaria","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2145-1463","authenticated-orcid":false,"given":"Eleonora","family":"Dalmasso","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Manzione","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Renal Transplantation Division, Department of Medical Sciences, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital, University of Turin, 10100 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Masturzo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5561-948X","authenticated-orcid":false,"given":"Massimo","family":"Torreggiani","sequence":"additional","affiliation":[{"name":"N\u00e9phrologie et Dialyse, Centre Hospitalier Le Mans, 72037 Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5797-3722","authenticated-orcid":false,"given":"Alberto","family":"Revelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SC2U, Citt\u00e0 della Salute e della Scienza, Sant\u2019Anna Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranca","family":"Cabiddu","sequence":"additional","affiliation":[{"name":"Nephrology, Department of Medical Science and Public Health, San Michele Hospital, G. Brotzu, University of Cagliari, 09047 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2632-4009","authenticated-orcid":false,"given":"Giorgina Barbara","family":"Piccoli","sequence":"additional","affiliation":[{"name":"N\u00e9phrologie et Dialyse, Centre Hospitalier Le Mans, 72037 Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,9]]},"reference":[{"key":"ref_1","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2013). KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Inter. 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