Lactiplantibacillus plantarum WJL ameliorates adverse effects of low-protein diet in chronic kidney disease via FGF21 modulation
Low-protein diet improves metabolic markers in CKD but triggers a FGF21 adaptive stress response; Lactiplantibacillus plantarum WJL was tested to mitigate associated catabolic effects.
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What the study showed
Low-protein diet reduced circulating uremic toxins, improved glucose tolerance, and remodeled gut microbiota in both murine models and non-diabetic CKD patients. In both settings, significant hepatic FGF21 induction was observed (+2.9-fold in humans; +28-fold in mice), correlating negatively with lean mass and positively with fat mass. Administration of Lp WJL was investigated as a strategy to counteract nutritional adverse effects of the diet.
How it was done
Study combining murine CKD models with a randomized controlled trial in non-diabetic CKD patients on low-protein diet, assessing glucose homeostasis, plasma uremic toxins, gut microbiota composition and function, and endocrine markers.
Risk of bias
The abstract does not report the RCT sample size or intervention duration, precluding assessment of statistical power. The large interspecies difference in FGF21 response magnitude limits translational inference.
What this study does NOT prove
The study does not prove that Lp WJL supplementation prevents lean mass loss or improves clinically relevant long-term renal outcomes.
In clinical practice
Findings indicate that low-protein diet in CKD engages endocrine and microbial adaptations with potential catabolic implications, warranting careful nutritional monitoring. Lp WJL supplementation remains experimental with no established clinical recommendation.
Limitations
The abstract does not report the RCT sample size or intervention duration, precluding assessment of statistical power. The large interspecies difference in FGF21 response magnitude limits translational inference.
Technical appendix
Version history
- 1.0 · 2026-07-14 — Auto-generated under Evidence Standard v1.0
Paid access: structured summary from public metadata; consult the original study at the source.