{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:00:24Z","timestamp":1791907224641,"version":"4.3.4"},"reference-count":129,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2017,5,13]],"date-time":"2017-05-13T00:00:00Z","timestamp":1494633600000},"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>The prevalence of chronic kidney disease (CKD) is high and it is gradually increasing. Individuals with CKD should introduce appropriate measures to hamper the progression of kidney function deterioration as well as prevent the development or progression of CKD-related diseases. A kidney-friendly diet may help to protect kidneys from further damage. Patients with kidney damage should limit the intake of certain foods to reduce the accumulation of unexcreted metabolic products and also to protect against hypertension, proteinuria and other heart and bone health problems. Despite the fact that the influence of certain types of nutrients has been widely studied in relation to kidney function and overall health in CKD patients, there are few studies on the impact of a specific diet on their survival. Animal studies demonstrated prolonged survival of rats with CKD fed with protein-restricted diets. In humans, the results of studies are conflicting. Some of them indicate slowing down of the progression of kidney disease and reduction in proteinuria, but other underline significant worsening of patients\u2019 nutritional state, which can be dangerous. A recent systemic study revealed that a healthy diet comprising many fruits and vegetables, fish, legumes, whole grains, and fibers and also the cutting down on red meat, sodium, and refined sugar intake was associated with lower mortality in people with kidney disease. The aim of this paper is to review the results of studies concerning the impact of diet on the survival of CKD patients.<\/jats:p>","DOI":"10.3390\/nu9050495","type":"journal-article","created":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T12:16:12Z","timestamp":1494850572000},"page":"495","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["The Effect of Diet on the Survival of Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"9","author":[{"given":"Jacek","family":"Rysz","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Franczyk","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Cia\u0142kowska-Rysz","sequence":"additional","affiliation":[{"name":"Palliative Medicine Unit, Chair of Oncology, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3322-5655","authenticated-orcid":false,"given":"Anna","family":"Gluba-Brz\u00f3zka","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hypertension and Family Medicine, WAM Teaching Hospital of Lodz, Zeromskiego 113, 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kidney Disease Outcomes Quality Initiative (K\/DOQI) (2004). K\/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am. J. Kidney Dis., 43, S1\u2013S290.","DOI":"10.1053\/j.ajkd.2004.03.003"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1093\/ndt\/gfs609","article-title":"Serum bicarbonate and mortality in adults in NHANES III","volume":"28","author":"Raphal","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"825","DOI":"10.7326\/0003-4819-158-11-201306040-00007","article-title":"Kidney Disease: Improving Global Outcomes 2012 and clinical practice guideline","volume":"158","author":"Stevens","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1053\/j.ajkd.2011.03.032","article-title":"Prehemodialysis care by dietitians and first-year mortality after initiation of hemodialysis","volume":"58","author":"Slinin","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3945\/ajcn.110.011221","article-title":"Diet quality and the risk of cardiovascular disease: The Women\u2019s Health Initiative (WHI)","volume":"94","author":"Belin","year":"2011","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jada.2004.01.005","article-title":"Healthy Eating Index scores are associated with blood nutrient concentrations in the third National Health and Nutrition Examination Survey","volume":"104","author":"Weinstein","year":"2004","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/MNH.0000000000000160","article-title":"Dietary interventions to improve outcomes in chronic kidney disease","volume":"24","author":"Goraya","year":"2015","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1038\/ki.2011.313","article-title":"Dietary acid reduction with fruits and vegetables or sodium bicarbonate reduces kidney injury in subjects with moderately reduced GFR due to hypertensive nephropathy","volume":"81","author":"Goraya","year":"2012","journal-title":"Kidney Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1038\/ki.2009.402","article-title":"Uremic toxins originating from colonic microbial metabolism","volume":"76","author":"Evenepoel","year":"2009","journal-title":"Kidney Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1056\/NEJMoa1200303","article-title":"Primary prevention of cardiovascular disease with a Mediterranean diet","volume":"368","author":"Estruch","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.3945\/ajcn.2009.28111","article-title":"Sugar-sweetened beverage consumption and the progression of chronic kidney disease in the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"90","author":"Bomback","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"160","DOI":"10.2215\/CJN.03260410","article-title":"Associations of sugar and artificially sweetened soda with albuminuria and kidney function decline in women","volume":"6","author":"Lin","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000357679","article-title":"Nutritional Therapy, Phosphate Control and Renal Protection","volume":"126","author":"Carrero","year":"2014","journal-title":"Nephron Clin. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/ndt\/gfr223","article-title":"Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease","volume":"27","author":"Brymora","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"602","DOI":"10.2215\/CJN.00600112","article-title":"Adherence to a Healthy Lifestyle and All-Cause Mortality in CKD","volume":"8","author":"Ricardo","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Parra, E., Gracia-Iguacel, C., Egido, J., and Ortiz, A. (2012). Phosphorus and Nutrition in Chronic Kidney Disease. Int. J. Nephrol.","DOI":"10.1155\/2012\/597605"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1681\/ASN.2008111205","article-title":"Bicarbonate supplementation slows progression of CKD and improves nutritional status","volume":"20","author":"Varagunam","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1053\/j.jrn.2013.01.001","article-title":"Etiology of the protein-energy wasting syndrome in chronic kidney disease: A consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM)","volume":"23","author":"Carrero","year":"2013","journal-title":"J. Ren. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/j.1525-139X.2005.00074.x","article-title":"Recent advances in understanding the malnutrition-inflammation-cachexia syndrome in chronic kidney disease patients: What is next?","volume":"18","year":"2005","journal-title":"Semin. Dial."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1053\/jren.2003.50005","article-title":"Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt\/V greater than 1","volume":"13","author":"Supasyndh","year":"2003","journal-title":"J. Ren. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"16026","DOI":"10.1038\/cddiscovery.2016.26","article-title":"Is low-protein diet a possible risk factor of malnutrition in chronic kidney disease patients?","volume":"2","author":"Noce","year":"2016","journal-title":"Cell Death Discov."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1038\/ncpneph0570","article-title":"Racial and survival paradoxes in chronic kidney disease","volume":"3","author":"Kovesdy","year":"2007","journal-title":"Nat. Clin. Pract. Nephrol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1159\/000082012","article-title":"Reverse epidemiology: A spurious hypothesis or a hardcore reality?","volume":"23","author":"Kilpatrick","year":"2005","journal-title":"Blood Purif."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2215\/CJN.08601209","article-title":"Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients","volume":"5","author":"Noori","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1525-139X.2007.00309.x","article-title":"Phosphorus homeostasis in normal health and in chronic kidney disease patients with special emphasis on dietary phosphorus intake","volume":"20","author":"Uribarri","year":"2007","journal-title":"Semin. Dial"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"620","DOI":"10.2215\/CJN.04620510","article-title":"Prescribed Dietary Phosphate Restriction and Survival among Hemodialysis Patients","volume":"6","author":"Lynch","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1093\/ndt\/gfh941","article-title":"Revisiting mortality predictability of serum albumin in the dialysis population: Time dependency, longitudinal changes and population-attributable fraction","volume":"20","author":"Kilpatrick","year":"2005","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1038\/ki.2011.118","article-title":"Nutrition and chronic kidney disease","volume":"80","author":"Fouque","year":"2011","journal-title":"Kidney Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.3945\/ajcn.2008.26665","article-title":"Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?","volume":"88","author":"Shinaberger","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0891-5849(96)00282-1","article-title":"Antioxidant effects of a supplemented very low protein diet in chronic renal failure","volume":"22","author":"Peuchant","year":"1997","journal-title":"Free Radic. Biol. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Fouque, D., and Laville, M. (2006). Low protein diets for chronic kidney disease in non-diabetic adults. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD001892.pub2"},{"key":"ref_32","first-page":"379","article-title":"Patient education for phosphorus management in chronic kidney disease","volume":"7","year":"2013","journal-title":"Patient Prefer. Adherence"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.2215\/CJN.00810110","article-title":"Serum Phosphate and Mortality in Patients with Chronic Kidney Disease","volume":"5","author":"Eddington","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_34","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":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_35","first-page":"16","article-title":"The \u201cphosphorus pyramid\u201d: A visual tool for dietary phosphate management in dialysis and CKD patients","volume":"20","author":"Piccoli","year":"2015","journal-title":"BMC Nephrol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1038\/ki.2013.147","article-title":"Prevention and treatment of protein energy wasting in chronic kidney disease patients: A consensus statement by the International Society of Renal Nutrition and Metabolism","volume":"84","author":"Ikizler","year":"2013","journal-title":"Kidney Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1681\/ASN.2004070602","article-title":"Serum phosphate levels and mortality risk among people with chronic kidney disease","volume":"16","author":"Kestenbaum","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.2215\/CJN.09250912","article-title":"Effects of dietary phosphate restriction and phosphate binders on FGF23 levels in CKD","volume":"8","author":"Isakova","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2909","DOI":"10.1093\/ndt\/gfm286","article-title":"High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients","volume":"22","author":"Voormolen","year":"2007","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1053\/j.ajkd.2011.12.025","article-title":"Phosphate binder use and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS): Evaluation of possible confounding by nutritional status","volume":"60","author":"Lopes","year":"2012","journal-title":"Am. J. Kidney Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1681\/ASN.V12102131","article-title":"Association of elevated serum PO(4), Ca \u00d7 PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients","volume":"12","author":"Ganesh","year":"2001","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1097\/01.ASN.0000113243.24155.2F","article-title":"Calcium, phosphate, and parathyroid hormone levels in combination and as a function of dialysis duration predict mortality: Evidence for the complexity of the association between mineral metabolism and outcomes","volume":"15","author":"Stevens","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1038\/ki.2008.644","article-title":"The emerging role of phosphate in vascular calcification","volume":"75","author":"Giachelli","year":"2009","journal-title":"Kidney Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1159\/000209248","article-title":"Impact of disturbances of calcium and phosphate metabolism on vascular calcification and clinical outcomes in patients with chronic kidney disease","volume":"27","author":"Nikolov","year":"2009","journal-title":"Blood Purif."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s40620-014-0071-2","article-title":"Effects of phosphorus-restricted diet and phosphate-binding therapy on outcomes in patients with chronic kidney disease","volume":"28","author":"Russo","year":"2015","journal-title":"J. Nephrol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lim, L.M., Kuo, H.T., Kuo, M.C., Chiu, Y.W., Lee, J.J., Hwang, S.J., Tsai, J.C., Hung, C.C., and Chen, H.C. (2014). Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3\u20134 patients. BMC Nephrol., 15.","DOI":"10.1186\/1471-2369-15-183"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1037\/0882-7974.13.4.584","article-title":"Human aging and duration judgments: A meta-analytic review","volume":"13","author":"Block","year":"1998","journal-title":"Psychol. Aging."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"825","DOI":"10.2215\/CJN.02101205","article-title":"Association of disorders in mineral metabolism with progression of chronic kidney disease","volume":"1","author":"Schwarz","year":"2006","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.ajkd.2008.03.020","article-title":"Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"52","author":"Tentori","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_50","first-page":"F813","article-title":"Effects of in vivo metabolic acidosis on midcortical bone ion composition","volume":"277","author":"Bushinsky","year":"1999","journal-title":"Am. J. Physiol."},{"key":"ref_51","first-page":"F586","article-title":"Endothelin-1 increases rat distal tubule acidification in vivo","volume":"273","author":"Wesson","year":"1997","journal-title":"Am. J. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1038\/ki.2009.6","article-title":"Increased tissue acid mediates a progressive decline in the glomerular filtration rate of animals with reduced nephron mass","volume":"75","author":"Wesson","year":"2009","journal-title":"Kidney Int."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"5086","DOI":"10.1074\/jbc.273.9.5086","article-title":"Low environmental pH is responsible for the induction of nitric-oxide synthase in macrophages. Evidence for involvement of nuclear factor-kappaB activation","volume":"273","author":"Bellocq","year":"1998","journal-title":"J. Biol. Chem."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000328742","article-title":"Activation of intrarenal renin-angiotensin system during metabolic acidosis","volume":"34","author":"Ng","year":"2011","journal-title":"Am. J. Nephrol."},{"key":"ref_55","first-page":"E154","article-title":"Intravenous acid infusion stimulates ACTH secretion in sheep","volume":"260","author":"Wood","year":"1991","journal-title":"Am. J. Physiol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Bellasi, A., Di Micco, L., Santoro, D., Marzocco, S., De Simone, E., Cozzolino, M., Di Lullo, L., Guastaferro, P., Di Iorio, B., and UBI study investigators (2016). Correction of metabolic acidosis improves insulin resistance in chronic kidney disease. BMC Nephrol., 17.","DOI":"10.1186\/s12882-016-0372-x"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/ki.2009.516","article-title":"A basic approach to CKD","volume":"77","author":"Simon","year":"2010","journal-title":"Kidney Int."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1053\/j.jrn.2014.10.019","article-title":"Insulin resistance as a therapeutic target for chronic kidney disease","volume":"25","author":"Teta","year":"2015","journal-title":"J. Ren. Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1038\/ki.2010.348","article-title":"Acid retention during kidney failure induces endothelin and aldosterone production which lead to progressive GFR decline, a situation ameliorated by alkali diet","volume":"78","author":"Wesson","year":"2010","journal-title":"Kidney Int."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"308","DOI":"10.2215\/CJN.06200615","article-title":"Bicarbonate Concentration, Acid-Base Status, and Mortality in the Health, Aging, and Body Composition Study","volume":"11","author":"Raphael","year":"2016","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1093\/ndt\/gfn633","article-title":"Association of serum bicarbonate levels with mortality in patients with non-dialysis-dependent CKD","volume":"24","author":"Kovesdy","year":"2009","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.2215\/CJN.03730411","article-title":"Serum bicarbonate and mortality in stage 3 and stage 4 chronic kidney disease","volume":"6","author":"Navaneethan","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1053\/ajkd.2001.20748","article-title":"National Kidney Foundation: K\/DOQI clinical practice guidelines for nutrition in chronic renal failure","volume":"37","author":"Kopple","year":"2000","journal-title":"Am. J. Kidney Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1159\/000443746","article-title":"Dietary acid load and incident chronic kidney disease: Results from the ARIC study","volume":"42","author":"Rebholz","year":"2015","journal-title":"Am. J. Nephrol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1038\/ki.2014.83","article-title":"Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate","volume":"86","author":"Goraya","year":"2014","journal-title":"Kidney Int."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Di Iorio, B.R., Di Micco, L., Marzocco, S., De Simone, E., De Blasio, A., Sirico, M.L., and Nardone, L. (2017). On behalf of UBI Study Group. Very Low-Protein Diet (VLPD) Reduces Metabolic Acidosis in Subjects with Chronic Kidney Disease: The \u201cNutritional Light Signal\u201d of the Renal Acid Load. Nutrients, 9.","DOI":"10.3390\/nu9010069"},{"key":"ref_67","unstructured":"National Kidney Foundation\u2013Kidney Disease Outcomes and Quality Initiative (2000). Clinical practice guidelines for nutrition in chronic renal failure: K\/DOQI, National Kidney Foundation. Am. J. Kidney Dis., 35, S1\u2013S140."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1093\/ckj\/sfw046","article-title":"Short-term effects of the DASH diet in adults with moderate chronic kidney disease: A pilot feeding study","volume":"9","author":"Tyson","year":"2016","journal-title":"Clin. Kidney J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"371","DOI":"10.2215\/CJN.02430312","article-title":"A Comparison of Treating Metabolic Acidosis in CKD Stage 4 Hypertensive Kidney Disease with Fruits and Vegetables or Sodium Bicarbonate","volume":"8","author":"Goraya","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1053\/j.ajkd.2010.03.023","article-title":"Serum bicarbonate and long-term outcomes in CKD","volume":"56","author":"Menon","year":"2010","journal-title":"Am. J. Kidney Dis."},{"key":"ref_71","first-page":"F1675","article-title":"Superiority of salt restriction over diuretics in reducing renal hypertrophy and injury in uninephrectomized SHR","volume":"258","author":"Benstein","year":"1990","journal-title":"Am. J. Physiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"F237","DOI":"10.1152\/ajprenal.00027.2009","article-title":"Vascular consequences of dietary salt intake","volume":"297","author":"Sanders","year":"2009","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3435","DOI":"10.1093\/ndt\/gfs354","article-title":"Salt intake in kidney disease\u2014A missed therapeutic opportunity?","volume":"27","author":"Navis","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1161\/HYPERTENSIONAHA.107.100701","article-title":"Relation of dietary salt and aldosterone to urinary protein excretion in subjects with resistant hypertension","volume":"51","author":"Pimenta","year":"2008","journal-title":"Hypertension"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1093\/ndt\/gfq772","article-title":"Endogenous cardiotonic steroids in chronic renal failure","volume":"26","author":"Kolmakova","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1038\/sj.ki.5002011","article-title":"The effect of a shift in sodium intake on renal hemodynamics is determined by body mass index in healthy young men","volume":"71","author":"Krikken","year":"2007","journal-title":"Kidney Int."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"d4366","DOI":"10.1136\/bmj.d4366","article-title":"Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: Randomised controlled trial","volume":"343","author":"Slagman","year":"2011","journal-title":"BMJ"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1681\/ASN.2013030285","article-title":"Randomized Trial of Dietary Sodium Restriction in CKD","volume":"24","author":"McMahon","year":"2013","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Campbell, K.L., Johnson, D.W., Bauer, J.D., Hawley, C.M., Isbel, N.M., Stowasser, M., Whitehead, J.P., Dimeski, G., and McMahon, E. (2014). A randomized trial of sodium-restriction on kidney function, fluid volume and adipokines in CKD patients. BMC Nephrol., 15.","DOI":"10.1186\/1471-2369-15-57"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Suckling, R.J., He, F.J., and Macgregor, G.A. (2010). Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD006763.pub2"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s00125-001-0763-8","article-title":"Short-term moderate sodium restriction induces relative hyperfiltration in normotensive normoalbuminuric Type I diabetes mellitus","volume":"45","author":"Luik","year":"2002","journal-title":"Diabetologia"},{"key":"ref_82","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":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1053\/j.jrn.2016.01.016","article-title":"Diet and Major Renal Outcomes: A Prospective Cohort Study. The NIH-AARP Diet and Health Study","volume":"26","author":"Smyth","year":"2016","journal-title":"J. Ren. Nutr."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1053\/j.ajkd.2014.02.013","article-title":"Dietary Patterns and Risk of Death and Progression to ESRD in Individuals with CKD: A Cohort Study","volume":"64","author":"Muntner","year":"2014","journal-title":"Am. J. Kidney Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1681\/ASN.2016030248","article-title":"Red Meat Intake and Risk of ESRD","volume":"28","author":"Lew","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.metabol.2015.03.008","article-title":"A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus","volume":"64","author":"Kim","year":"2015","journal-title":"Metabolism"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"F919","DOI":"10.1152\/ajprenal.00068.2011","article-title":"The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease","volume":"301","author":"Odermatt","year":"2011","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1161\/CIRCULATIONAHA.108.771881","article-title":"Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women","volume":"18","author":"Heidemann","year":"2008","journal-title":"Circulation"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jada.2004.01.010","article-title":"Dietary patterns and health outcomes","volume":"104","author":"Kant","year":"2004","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1161\/CIRCULATIONAHA.105.603910","article-title":"Impact of dietary patterns and interventions on cardiovascular health","volume":"114","author":"Zarraga","year":"2006","journal-title":"Circulation"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"836","DOI":"10.2215\/CJN.08001109","article-title":"Associations of diet with albuminuria and kidney function decline","volume":"5","author":"Lin","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1053\/j.ajkd.2010.09.027","article-title":"Association of dietary patterns with albuminuria and kidney function decline in older white women: A subgroup analysis from the Nurses\u2019 Health Study","volume":"57","author":"Lin","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"F1256","DOI":"10.1152\/ajprenal.00181.2007","article-title":"Fructose, but not dextrose, accelerates the progression of chronic kidney disease","volume":"293","author":"Gersch","year":"2007","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Shoham, D.A., Durazo-Arvizu, R., Kramer, H., Luke, A., Vupputuri, S., Kshirsagar, A., and Cooper, R.S. (2008). Sugary soda consumption and albuminuria: Results from the National Health and Nutrition Examination Survey, 1999\u20132004. PLoS ONE, 3.","DOI":"10.1371\/journal.pone.0003431"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"814","DOI":"10.2174\/138161210790883561","article-title":"The effects of Italian Mediterranean Organic Diet (IMOD) on health status","volume":"16","author":"Noce","year":"2010","journal-title":"Curr. Pharm. Des."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.2215\/CJN.01780213","article-title":"Mediterranean Diet, Kidney Function, and Mortality in Men with CKD","volume":"8","author":"Huang","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1056\/NEJMoa025039","article-title":"Adherence to a Mediterranean diet and survival in a Greek population","volume":"348","author":"Trichopoulou","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"967","DOI":"10.3945\/ajcn.2010.29345","article-title":"Mediterranean and carbohydrate-restricted diets and mortality among elderly men: A cohort study in Sweden","volume":"92","author":"Becker","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.3945\/ajcn.2010.29673","article-title":"Accruing evidence on benefits of adherence to the Mediterranean diet on health: An updated systematic review and meta-analysis","volume":"92","author":"Sofi","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Piccoli, G.B., Nazha, M., and Capizzi, I. (2016). Patient Survival and Costs on Moderately Restricted Low-Protein Diets in Advanced CKD: Equivalent Survival at Lower Costs?. Nutrients, 8.","DOI":"10.3390\/nu8120758"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.nut.2014.01.004","article-title":"Which low-protein diet for which CKD patient? An observational, personalized approach","volume":"30","author":"Piccoli","year":"2014","journal-title":"Nutrition"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/sdi.12132","article-title":"Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?","volume":"26","author":"Aparicio","year":"2013","journal-title":"Semin. Dial."},{"key":"ref_103","first-page":"F85","article-title":"Hyperfiltration in remnant nephrons: A potentially adverse response to renal ablation","volume":"241","author":"Hostetter","year":"1981","journal-title":"Am. J. Physiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1038\/ki.2010.539","article-title":"Low-protein diet supplemented with ketoacids reduces the severity of renal disease in 5\/6 nephrectomized rats: A role for KLF15","volume":"79","author":"Gao","year":"2011","journal-title":"Kidney Int."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/ndt\/gfu340","article-title":"Low-protein diets in chronic kidney disease: Are we finally reaching a consensus?","volume":"30","author":"Fouque","year":"2015","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.1172\/JCI119432","article-title":"Mechanisms permitting nephrotic patients to achieve nitrogen equilibrium with a protein-restricted diet","volume":"99","author":"Maroni","year":"1997","journal-title":"J. Clin. Investig."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1681\/ASN.V651379","article-title":"Survival on dialysis among chronic renal failure patients treated with a supplemented low-protein diet before dialysis","volume":"6","author":"Coresh","year":"1995","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ajcn\/70.3.412","article-title":"Whole-grain consumption and risk of coronary heart disease: Results from the Nurses\u2019 Health Study","volume":"70","author":"Liu","year":"1999","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"544S","DOI":"10.1093\/ajcn\/78.3.544S","article-title":"Plant-based foods and prevention of cardiovascular disease: An overview","volume":"78","author":"Hu","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1038\/ncpneph0524","article-title":"Eleven reasons to control the protein intake of patients with chronic kidney disease","volume":"3","author":"Fouque","year":"2007","journal-title":"Nat. Clin. Pract. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/ndt\/gfu251","article-title":"Very low-protein diet plus ketoacids in chronic kidney disease and risk of death during end-stage renal disease: A historical cohort controlled study","volume":"30","author":"Bellizzi","year":"2015","journal-title":"Nephrol. Dial. Transplan."},{"key":"ref_112","first-page":"143","article-title":"Effects of low-protein diet supplemented with ketoacids on plasma lipids in adult chronic renal failure","volume":"22","author":"Bernard","year":"1996","journal-title":"Miner. Electrolyte Metab."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/ndt\/gfm576","article-title":"Metabolic effects of two low protein diets in chronic kidney disease stage IV-V: A randomized controlled trial","volume":"23","author":"Cianciaruso","year":"2008","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/sj.ki.5001955","article-title":"Very low protein diet supplemented with ketoacids improves blood pressure control in chronic kidney disease","volume":"71","author":"Bellizzi","year":"2007","journal-title":"Kidney Int."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1093\/ndt\/gfs477","article-title":"Phosphate attenuates the antiproteinuric effect of very low protein diet in CKD patients","volume":"28","author":"Bellizzi","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1046\/j.1523-1755.2003.00884.x","article-title":"Nutrition in hemodialysis patients previously on a supplemented very low protein diet","volume":"63","author":"Vendrely","year":"2003","journal-title":"Kidney Int."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"627","DOI":"10.7326\/0003-4819-124-7-199604010-00002","article-title":"The effect of dietary protein restriction on the progression of diabetic and non-diabetic renal diseases: A meta-analysis","volume":"124","author":"Pedrini","year":"1996","journal-title":"Ann. Intern. Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1053\/j.ajkd.2007.02.278","article-title":"Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: A prospective randomized multicenter controlled study","volume":"49","author":"Brunori","year":"2007","journal-title":"Am. J. Kidney Dis."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1159\/000346628","article-title":"Very low protein diet reduces indoxyl sulfate levels in chronic kidney disease","volume":"35","author":"Marzocco","year":"2013","journal-title":"Blood Purif."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.2215\/CJN.03980609","article-title":"Serum indoxyl sulfate is associated with vascular disease and mortality in chronic kidney disease patients","volume":"4","author":"Barreto","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"581","DOI":"10.2215\/CJN.07640711","article-title":"Acute effects of very-low-protein diet on FGF23 levels: A randomized study","volume":"7","author":"Torraca","year":"2012","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1046\/j.1523-1755.2003.00282.x","article-title":"Supplemented very low protein diet ameliorates responsiveness to erythropoietin in chronic renal failure","volume":"64","author":"Minutolo","year":"2003","journal-title":"Kidney Int."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1159\/000450892","article-title":"Relationship between Anemia and Serum Concentrations of Calcium and Phosphorus in Advanced Non-Dialysis-Dependent Chronic Kidney Disease","volume":"135","author":"Boronat","year":"2017","journal-title":"Nephron"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1681\/ASN.2011111078","article-title":"Mechanisms of anemia in CKD","volume":"23","author":"Babitt","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s40620-014-0129-1","article-title":"Parathyroid hormone may be an early predictor of low serum hemoglobin concentration in patients with not advanced stages of chronic kidney disease","volume":"28","author":"Russo","year":"2015","journal-title":"J. Nephrol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/ndt\/gfv297","article-title":"Serum phosphorus and association with anemia among a large diverse population with and without chronic kidney disease","volume":"31","author":"Tran","year":"2016","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1053\/j.ajkd.2008.08.009","article-title":"Effect of a very low-protein diet on outcomes: Long-term follow-up of the Modification of Diet in Renal Disease (MDRD) study","volume":"53","author":"Menon","year":"2009","journal-title":"Am. J. Kidney Dis."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1093\/ndt\/15.12.1986","article-title":"Low protein diets delay end-stage renal disease in non-diabetic adults with chronic renal failure","volume":"15","author":"Fouque","year":"2000","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"969","DOI":"10.3945\/ajcn.2009.27980","article-title":"Long-term outcome on renal replacement therapy in patients who previously received a keto acid supplemented very-low-protein diet","volume":"90","author":"Chauveau","year":"2009","journal-title":"Am. J. Clin. 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