Dietary plant and animal protein intake and decline in estimated glomerular filtration rate among elderly women: A 10-year longitudinal cohort study

Author Identifier

Joshua Lewis

ORCID : 0000-0003-1003-8443

Jonathan Hodgson

ORCID : 0000-0001-6184-7764

Document Type

Journal Article

Publication Title

Nephrology Dialysis Transplantation


Oxford University Press


School of Medical and Health Sciences




Healthway Health Promotion Foundation of Western Australia National Health and Medical Research Council Fond de Recherche du Que ́bec en Sante ́

Grant Number

NHMRC Number : 254627, 303169, GNT1151246

Grant Link

http://purl.org/au-research/grants/nhmrc/254627 http://purl.org/au-research/grants/nhmrc/303169 http://purl.org/au-research/grants/nhmrc/GNT1151246


Bernier-Jean, A., Prince, R. L., Lewis, J. R., Craig, J. C., Hodgson, J. M., Lim, W. H., . . . Wong, G. (2021). Dietary plant and animal protein intake and decline in estimated glomerular filtration rate among elderly women: A 10-year longitudinal cohort study. Nephrology Dialysis Transplantation, 36(9), 1640-1647. https://doi.org/10.1093/ndt/gfaa081


Background Many older women demonstrate an age-related accelerating rate of renal decline that is associated with increased rates of bone disease, cardiovascular disease and mortality. Population-based protein restriction has been studied principally in patients with reduced renal function. In this investigation, we examined the hypothesis of a differential effect of plant-derived protein compared with animal-derived protein on renal function in older women. Methods We assessed dietary intake from a validated food frequency questionnaire and the estimated glomerular filtration rate (eGFR) (using the Chronic Kidney Disease Epidemiology Collaboration creatinine and cystatin C equation) at baseline, 5 and 10 years in the Longitudinal Study of Aging Women cohort. We tested the association between plant- and animal-sourced protein intake and kidney function using linear mixed modeling. Results A total of 1374 Caucasian women [mean (standard deviation, SD) age = 75 years (2.7) and mean (SD) baseline eGFR = 65.6 mL/min/1.73 m2 (13.1)] contributed to the analysis. The average decline in eGFR was 0.64 mL/min/1.73 m2/year [95% confidence interval (CI) 0.56–0.72]. Higher intakes of plant-sourced protein were associated with slower declines in eGFR after adjusting for covariates including animal protein and energy intake (P = 0.03). For each 10 g of plant protein, the yearly decline in eGFR was reduced by 0.12 mL/min/1.73 m2 (95% CI 0.01–0.23), principally associated with fruit-, vegetable- and nut-derived protein. The intake of animal protein was not associated with eGFR decline (P = 0.84). Conclusions Older women consuming a diet that is richer in plant-sourced protein have a slower decline in kidney function. These data extend support for the health benefits of plant-rich diets in the general population to maintain kidney health.



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