In a four-week trial of 36 people with severe kidney disease, a diet with 70% of its protein from plants lowered a gut-made toxin called TMAO and shifted gut bacteria in a healthier direction. It also did not raise blood potassium, a common worry with plant-heavy diets in kidney patients.
1
Serum TMAO dropped significantly in the 70% plant-protein group versus control (difference -4.6 μg/mL, 95% CI -7.2 to -2.0; FDR-adjusted P=0.003).
2
No significant between-group differences in indoxyl sulfate (-0.8 μg/mL) or p-cresyl sulfate (-0.9 μg/mL); the plant diet raised venous bicarbonate, calcium, and serum acetate while lowering parathyroid hormone.
3
Pro-inflammatory gut genera decreased and SCFA-producing genera increased, with no significant difference in serum potassium change; 36 patients (median eGFR 13), 94% adherence, 4 weeks.
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