Abstract: FR-PO1112
Adherence to a Low-Protein Diet Is Associated with Slower Progression of CKD: Insights from a Fourteen-Year Brazilian Cohort
Session Information
- Health Maintenance, Nutrition, and Metabolism
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Mafra, Denise, Universidade Federal Fluminense, Niterói, RJ, Brazil
- Brum, Isabela de Souza da Costa, Universidade Federal Fluminense, Niterói, RJ, Brazil
- Correa, Hugo de Luca, Universidade Catolica de Brasilia, Taguatinga, Federal District, Brazil
- Rosa, Thiago S., Universidade Catolica de Brasilia, Taguatinga, Federal District, Brazil
- Fouque, Denis, Universite de Lyon, Lyon, Auvergne-Rhône-Alpes , France
Background
In early chronic kidney disease (CKD), a low-protein diet (LPD) may reduce glomerular hyperfiltration and delay progression, but long-term data from low- and middle-income countries are limited.This study aimed to evaluate the association between of adherence to an LPD and CKD progression in a large Brazilian cohort over 14 years.
Methods
This retrospective study analyzed 438 Brazilian adults with CKD stages 3–5 non-dialysis (2010–2024) from a single center in Brazil. Based on 24-hour dietary recall was classified as "Adherence" to an LPD (≥ 50% of visits with protein intake ≤ 0.8 g/kg/day ±10%) or “non-adherent” (< 50% of visits with protein intake > 0.88 g/kg/day). A linear mixed model was used to evaluate the impact of adherence to an LPD on estimated glomerular filtration rate (eGFR) decline over time, adjusting for clinical and biochemical confounders.
Results
Of the patients, 306 were adherents to the LPD (63.5 ± 13.8 years, eGFR 33.6 ± 13.7 mL/min) and 132 were non-adherents (62.9 ± 15.3 years, eGFR 31.5 ± 13.2 mL/min). Over time, adherence to LPD was associated with a significantly slower decline in eGFR (p = 0.042) (Figure 1). The model revealed a significant positive coefficient for eGFR and negative coefficients for urea, creatinine, and phosphorus (Table 1).
Conclusion
Adherence to a low-protein diet is linked to slower CKD progression and better biochemical profiles, supporting its long-term nephroprotective role. These findings emphasize the importance of structured dietary interventions in routine CKD treatment.
Impact of adherence on biochemical variables and kidney function.
| Variables | Coefficient | P value |
| eGFR | 2.306663 | 0.000618 |
| Urea | -7.48602 | 0.000075 |
| Creatinine | -0.18257 | 0.019119 |
| Phosphorus | -0.12403 | 0.001704 |
eGFR: estimated glomerular filtration rate.
Funding
- Government Support – Non-U.S.