High-Diversity Plant-Based Diet and Gut Microbiome, Plasma Metabolome, and Symptoms in Adults with CKD
Abstract
Visual Abstract Key Points Increasing plant diversity (≥30 plant foods/wk) reduced symptom burden and shifted the gut microbiome toward beneficial metabolite production. Increasing plant diversity was more effective for individuals with more advanced kidney disease and higher levels of uremic toxins at baseline. Increasing plant diversity, in addition to usual diet care, resulted in a substantial reduction in potential renal acid load of 47%. Background Research suggests that eating a plant-dominant dietary pattern is beneficial to people with CKD. The aim was to investigate how increasing the diversity of plant food intake would affect metabolomic, microbiome, and clinical parameters in people with CKD. Methods This study was a cross-over, randomized controlled trial involving 25 Australian adults diagnosed with stage 3–4 CKD. Participants were randomly allocated to follow two diets for 6 weeks each, separated by a minimum 4-week washout period: a high-diversity plant-based diet (HDPD, ≥30 unique plant foods weekly) and a low-diversity plant-based diet (LDPD, ≤15 unique plant foods weekly), alongside a usual kidney diet prescription. Data collection was completed at four time points (beginning and end of each intervention period). Primary outcome included a change in uremic toxins (indoxyl sulfate and p-cresyl sulfate) concentrations. Secondary and exploratory outcomes included diet quality and nutritional status, fecal microbiome composition and diversity, plasma…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 25 participants or records.
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