The role of plant-based diets in the management of CKD: Implications for practice

Dietary management of chronic kidney disease (CKD) is complex. Dietary recommendations prescribed to people with CKD often focus on restricting individual nutrients, and patients have described these interventions as confusing and challenging to implement. A growing body of research supports the promotion of healthy dietary patterns that are predominantly plant-based over nutrient-focused prescriptions in order to help control a range of clinical risk factors and outcomes in CKD. Plant-based diets may improve several risk factors and symptoms of CKD, including blood pressure, blood sugar, and weight maintenance, as well as providing dietary components that support a healthy gut microbiome. However, there is limited research exploring the impact of plant-based diets, using a whole dietary approach, in people with CKD. This thesis aimed to address this gap by exploring how plant-based diets differ in their health benefits and their acceptability and feasibility for CKD management. Specifically, this thesis hypothesised that diets higher in the amount and variety of plant foods are a viable alternative to more commonly consumed diets in people with CKD, through favourable changes to the gut microbiome, and may have positive clinical and practice implications.