Medical Nutrition Therapy with a Plant-Based Diet in Pregnant Women with Chronic Kidney Disease: A Case Series

Authors

  • Otilia Perichart-Perera Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
  • Lizet Ibarra-González Dietetic and Nutrition Service, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
  • Alejandra Orozco-Guillén Critical Medicine Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
  • Julieta Hernández-Corona Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
  • Larissa Hernández-Hernández Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
  • Margarita Flores-Reyes Master in Clinical Nutrition, School of Public Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
  • Mario Rodríguez-Bosch Obstetrics and Gynecology Subdirection, Instituto Nacional de Perinatología, Ciudad de México, México
  • Ameyalli M Rodriguez-Cano Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México

DOI:

https://doi.org/10.14306/renhyd.30.3.2718

Keywords:

Prenatal nutrition, Traditional diet, Pregnancy complications, Infant-newborn, Renal insufficiency, Case series

Abstract

Background: Chronic kidney disease (CKD) is a global health problem. Pregnancies in women with CKD face an increased risk of adverse perinatal outcomes. Despite limited data, nutritional care remains a crucial component of multidisciplinary treatment for these women. The aim was to describe clinical and metabolic status and perinatal outcomes in pregnant women with CKD receiving intensive medical and nutritional care, including the recommendation of a plant-based diet (PBD).

Methods: Retrospective analysis of 7 CKD-pregnancies. Participants received care from a perinatal nephrologist, routine obstetric follow-up, and medical nutrition therapy comprising a PBD, micronutrient supplementation, counseling, and education. Renal, nutritional and metabolic status were obtained from institutional records. Perinatal outcomes assessed included preeclampsia, gestational diabetes (GDM), preterm, hospitalization, hemodialysis (HD), intrauterine growth restriction, fetal loss, and neonatal nutritional status.

Results: Six women had stage 4 CKD. Most (n=5) received outpatient care; none required HD. Glomerular filtration rate and proteinuria remained stable in all women. Five women maintained or improved baseline creatinine (peak ≤3.0mg/dL). Third-trimester urea nitrogen was 31.3±11.3mg/dl, and albumin 2.97±0.09g/dl. No cases of GDM or fetal loss were observed, and one woman developed preeclampsia. All neonates were born alive. Neonatal outcomes reflected the high-risk nature of CKD pregnancies: three (42%) were preterm and four (57%) presented wasting. Newborn nutritional indices considering length and head circumference were normal.

Conclusion: In this case series of women with CKD receiving intensive medical and nutritional care, complications consistent with CKD pregnancies were observed, although with a low frequency of GDM, preeclampsia, fetal loss, and neonatal stunting. None of the women required initiation of HD, and renal function remained stable.

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Published

2026-06-04

How to Cite

Perichart-Perera, O., Ibarra-González, L., Orozco-Guillén, A., Hernández-Corona, J., Hernández-Hernández, L., Flores-Reyes, M., … Rodriguez-Cano, A. M. (2026). Medical Nutrition Therapy with a Plant-Based Diet in Pregnant Women with Chronic Kidney Disease: A Case Series. Spanish Journal of Human Nutrition and Dietetics. https://doi.org/10.14306/renhyd.30.3.2718

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Copyright (c) 2020 Otilia Perichart-Perera, Lizet Ibarra-González, Alejandra Orozco-Guillén, Julieta Hernández-Corona, Larissa Hernández-Hernández, Margarita Flores-Reyes, Mario Rodríguez-Bosch, Ameyalli M Rodriguez-Cano

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