Beyond Protein Restriction: Comparative eADI-17-Estimated Anti-Inflammatory Profiles of Four Renal Diets
- 1Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Abstract
Background/Objectives: Chronic low-grade inflammation contributes to chronic kidney disease (CKD) progression and cardiovascular complications. Although nutritional therapy is central to CKD management, the estimated anti-inflammatory profiles of renal diets remain poorly characterized. Methods: We analyzed 40 daily menus with broadly comparable, although not identical, energy content (10 per dietary pattern): Mediterranean renal diet (MedRen; 0.8 g protein/kg), vegan diet (0.7 g/kg), conventional low-protein diet (LPD; 0.6 g/kg), and supplemented very-low-protein diet (sVLPD; 0.3 g/kg). Dietary anti-inflammatory potential was estimated using the 17-component empirical Anti-inflammatory Diet Index (eADI-17), with higher scores indicating a more favorable profile. Groups were compared using exploratory non-parametric tests with multiple-comparison correction; nutrient associations were assessed using Spearman correlations with false-discovery-rate correction. Results: Mean eADI-17 scores were 11.90 ± 0.66 for MedRen, 9.75 ± 0.63 for vegan, 8.90 ± 1.10 for LPD, and 8.40 ± 0.52 for sVLPD. MedRen scored higher than all other diets, and vegan scored higher than sVLPD. In pooled analyses, eADI-17 correlated positively with total protein and phosphorus and negatively with vitamin C and total carbohydrate; none of these associations remained significant after accounting for dietary-group membership. Conclusions: The eADI-17-estimated anti-inflammatory potential of renal diets depends on the overall dietary pattern and does not necessarily improve with greater protein restriction. Because eADI-17 is an indirect food-based index and inflammatory biomarkers were not measured, these findings are hypothesis-generating and require validation in studies of actual intake, biomarkers, and clinical outcomes.
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BibTeX
@article{dalessandro2026beyond,
title = {{Beyond Protein Restriction: Comparative eADI-17-Estimated Anti-Inflammatory Profiles of Four Renal Diets}},
author = {Claudia D’Alessandro and Adamasco Cupisti and Vincenzo Panichi and Diego Moriconi and Domenico Giannese},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203395},
url = {https://www.mdpi.com/2072-6643/18/20/3395},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Beyond Protein Restriction: Comparative eADI-17-Estimated Anti-Inflammatory Profiles of Four Renal Diets
AU - Claudia D’Alessandro
AU - Adamasco Cupisti
AU - Vincenzo Panichi
AU - Diego Moriconi
AU - Domenico Giannese
PY - 2026
DA - 2026/10/16
JO - Nutrients
DO - 10.3390/nu18203395
UR - https://www.mdpi.com/2072-6643/18/20/3395
AB - Background/Objectives: Chronic low-grade inflammation contributes to chronic kidney disease (CKD) progression and cardiovascular complications. Although nutritional therapy is central to CKD management, the estimated anti-inflammatory profiles of renal diets remain poorly characterized. Methods: We analyzed 40 daily menus with broadly comparable, although not identical, energy content (10 per dietary pattern): Mediterranean renal diet (MedRen; 0.8 g protein/kg), vegan diet (0.7 g/kg), conventional low-protein diet (LPD; 0.6 g/kg), and supplemented very-low-protein diet (sVLPD; 0.3 g/kg). Dietary anti-inflammatory potential was estimated using the 17-component empirical Anti-inflammatory Diet Index (eADI-17), with higher scores indicating a more favorable profile. Groups were compared using exploratory non-parametric tests with multiple-comparison correction; nutrient associations were assessed using Spearman correlations with false-discovery-rate correction. Results: Mean eADI-17 scores were 11.90 ± 0.66 for MedRen, 9.75 ± 0.63 for vegan, 8.90 ± 1.10 for LPD, and 8.40 ± 0.52 for sVLPD. MedRen scored higher than all other diets, and vegan scored higher than sVLPD. In pooled analyses, eADI-17 correlated positively with total protein and phosphorus and negatively with vitamin C and total carbohydrate; none of these associations remained significant after accounting for dietary-group membership. Conclusions: The eADI-17-estimated anti-inflammatory potential of renal diets depends on the overall dietary pattern and does not necessarily improve with greater protein restriction. Because eADI-17 is an indirect food-based index and inflammatory biomarkers were not measured, these findings are hypothesis-generating and require validation in studies of actual intake, biomarkers, and clinical outcomes.
SN - 2072-6643
ER -