Abstract
Background/Objectives:
There is a growing body of evidence to indicate that soy protein consumption may have a beneficial effect on kidney function. We performed a meta-analysis to evaluate the effects of soy protein consumption compared with animal protein consumption in patients with pre-dialysis chronic kidney disease (CKD).
Subjects/Methods:
We conducted a structured electronic search of the databases PubMed, EMBASE, Cochrane Library and Chinese Biological Medicine for randomized controlled trials published up to March 2014. The outcome measures were serum creatinine (SCR), triglyceride (TG), total cholesterol (TC), calcium (Ca) and phosphorus concentrations. Weighted or standard mean differences were calculated for net changes using random-effects models.
Results:
The meta-analysis consisted of nine trials, comprising 197 subjects. Soy protein intake significantly reduced SCR and serum phosphorus concentrations. The mean difference was −6.231 μmol/l (95% confidence interval (CI): −11.109, −1.352 μmol/l) for SCR (P=0.012) and −0.804 (95% CI: −1.143, −0.464 μmol/l) for serum phosphorus (P=0.00). It also significantly reduced serum TG, with a pooled estimated change of −0.223 mmol/l (95% CI: −0.396, −0.051 mmol/l; P=0.011) after the exclusion of one trial indicated by sensitivity analyses. No statistically significant effects were observed for TC (−0.135 mmol/l (95% CI: −0.289, 0.019 mmol/l)) or Ca (0.023 mmol/l (95% CI: −0.016, 0.062 mmol/l)).
Conclusions:
The meta-analysis suggested a protective effect of soy protein consumption on SCR and serum phosphorus concentrations in pre-dialysis CKD patients. It may also have a significant effect on lowering serum TG concentrations. However, nonsignificant effects on TC and Ca were observed. Evidence was limited because of the relatively small number of available trials and subjects.
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References
Eknoyan G, Lameire N, Barsoum R, Eckardt K, Levin A, Levin N . The burden of kidney disease: improving global outcomes. Kidney Int 2004; 66: 1310–1314.
Chan AYM, Cheng MLL, Keil LC, Myers BD . Functional response of healthy and diseased glomeruli to a large protein-rich meal. J Clin Invest 1988; 81: 245–254.
Brenner BM, Meyer TW, Hostetter TH . Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med 1982; 307: 652–659.
Zeller KR . Low-protein diets in renal disease. Diabetes Care 1991; 14: 856–866.
Pedrini MT, Levey AS, Lau J, Chalmers TC, Wang PH . The effect of dietary protein restriction on the progression of diabetic and non-diabetic renal disease: a meta-analysis. Ann Intern Med 1996; 124: 627–632.
Fougue D, Aparicio M . Eleven reasons to control the protein intake of patients with chronic kidney disease. Nat Clin Pract Nephrol 2007; 3: 383–392.
Eyre S, Attman PO, Haraldsson B . Positive effects of protein restriction in patients with chronic kidney disease. J Ren Nutr 2008; 18: 269–280.
Velasquez MT, Bhathena SJ . Dietary phytoestrogens: a possible role in renal disease protection. Am J Kidney Dis 2001; 37: 1056–1068.
Anderson JW, Blake JE, Turner J, Smith BM . Effects of soy protein on renal function and proteinuria in patients with type 2 diabetes. Am J Clin Nutr 1998; 68, S1347–S1353.
Anderson JW . Beneficial effects of soy protein consumption for renal function. Asia Pac J Clin Nutr 2008; 17: 324–328.
Tomobe K, Philbrick DJ, Ogborn MR, Takahashi H, Holub BJ . Effect of dietary soy protein and genistein on disease progression in mice with polycystic kidney disease. Am J Kidney Dis 1998; 31: 55–61.
Ogborn MR, Bankovic-Calic N, Shoesmith C, Buist R, Peeling J . Soy protein modification of rat polycystic kidney disease. Am J Physiol 1998; 274: F541–F549.
Aukema HM, Housini I, Rawling JM . Dietary soy protein effects on inherited polycystic kidney disease are influenced by gender and protein level. J Am Soc Nephrol 1999; 10: 300–308.
Walls J, Williams AJ . Influence of soya protein on the natural history of a remnant kidney model in the rat. Contrib Nephrol 1988; 60: 179–187.
Williams AJ, Baker F, Walls J . Effect of varying quantity and quality of dietary protein intake in experimental renal disease in rats. Nephron 1987; 46: 83–90.
Fair DE, Ogborn MR, Weiler HA, Bankovic-Calic N, Nitschmann EP, Fitzpatrick-Wong SC et al. Dietary soy protein attenuates renal disease progression after 1 and 3 weeks in Han: SPRD-cy Weanling rats. J Nutr 2004; 134: 1504–1507.
Barsotti G, Morelli E, Cupisti A, Bertoncini P, Giovannetti S . A special, supplemented ‘vegan’ diet for nephrotic patients. Am J Nephrol 1991; 11: 380–385.
Gentile MG, Fellin G, Cofano F, Delle FA, Manna G, Ciceri R et al. Treatment of proteinuric patients with a vegetarian soy diet and fish oil. Clin Nephrol 1993; 40: 315–320.
D’Amico G, Gentile MG, Manna G, Fellin G, Ciceri R, Cofano F et al. Effect of vegetarian soy diet on hyperlipidaemia in nephrotic syndrome. Lancet 1992; 339: 1131–1134.
Higgins JP, Thompson SG, Deeks JJ, Altman DG . Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–560.
DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177–188.
Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple graphical test. BMJ 1997; 315: 629–634.
Soroka N, Silverberg DS, Greemland M, Birk Y, Blum M, Peer G . Comparison of a vegetable-based (soya) and an animal-based low-protein diet in predialysis chronic renal failure patients. Nephron 1998; 79, 173–180.
Azadbakht L, Shakerhosseini R, Atabak S, Jamshidian M, Mehrabi Y, Esmaill-Zadeh A . Beneficiary effect of dietary soy protein on lowering plasma levels of lipid and improving kidney function in type II diabetes with nephropathy. Eur J Clin Nutr 2003; 57: 1292–1295.
Mao H The effects of low soy protein diet on diabetic nephropathy. Clin Med 2004; 24, 14–15. (article in Chinese).
Teixeira SR, Tappenden KA, Carson L, Jones R, Prabhudesai M, Marshall WP . Isolated soy protein consumption reduces urinary albumin excretion and improves the serum lipid profile in men with type 2 diabetes mellitus and nephropathy. J Nutr 2004; 134: 1874–1880.
Azadbakht L, Atabak S, Esmaillzadeh A . Soy protein intake, cardiorenal indices, and C-reactive protein in type 2 diabetes with nephropathy: a longitudinal randomized clinical trial. Diabetes Care 2008; 31: 648–654.
Azadbakht L, Esmaillzadeh A . Soy-protein consumption and kidney-related biomarkers among type 2 diabetics: a crossover, randomized clinical trial. J Ren Nutr 2009; 19: 479–486.
Zhang HM, Xu JM, Chang LY, Yu DR, Yang RC, Wang YJ . A clinical trial of different low protein diets on chronic renal failure. Chin J Integr Tradit Western Nephrol 2010; 6: 502–505. (article in Chinese).
Kao TW, Kuo YH, Lin CY, Chiang CK, Huang JW, Lin SL . Effects of soy protein and nutrition education on patients with chronic kidney disease. Kidney Res Clin Pract 2012; 31: A43.
Anderson JW, Bush HM . Soy protein effects on serum lipoproteins: a quality assessment and meta-analysis of randomized controlled studies. J Am Coll Nutr 2011; 30: 79–91.
Wang Y, Jones PJH, Ausman LM, Lichtenstein AH . Soy protein reduces triglyceride levels and triglyceride fatty acid fractional synthesis rate in hypercholesterolemic subjects. Atherosclerosis 2004; 173, 269–275.
Zhan S, Ho SC . Meta-analysis of the effects of soy protein containing isoflavones on the lipid profile. Am J Clin Nutr 2005; 81, 397–408.
Reynolds K, Ashley C, Lees KA, Nguyen A, Bujnowski D, He J . A meta-analysis of the effect of soy protein supplementation on serum lipids. Am J Cardiol 2006; 98, 633–640.
Erdman JW . Soy protein and cardiovascular disease: a statement for healthcare professionals from the Nutrition Committee of the AHA. Circulation 2000; 102: 2555–2559.
Hermansen K, Sondergaard M, Hoie L, Carstensen M, Brock B . Beneficial effects of a soy-based dietary supplement on lipid levels and cardiovascular risk markers in type 2 diabetic subjects. Diabetes Care 2001; 24, 228–233.
Chen ST, Ferng SH, Yang CS, Peng SJ, Lee HR, Chen JR . Variable effects of soy protein on plasma lipids in hyperlipidemic and normalipidemic hemodialysis patients. Am J Kidney Dis 2005; 46, 1099–1106.
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AUTHOR CONTRIBUTIONS
JL designed this article and supported the research. JZ reviewed the search results, conducted the primary data abstraction, performed the statistical analysis, and drafted the review. JS conducted the secondary data abstraction. FT assisted the statistical analysis. All authors read and approved this article.
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Zhang, J., Liu, J., Su, J. et al. The effects of soy protein on chronic kidney disease: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 68, 987–993 (2014). https://doi.org/10.1038/ejcn.2014.112
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DOI: https://doi.org/10.1038/ejcn.2014.112
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