Yes, I agree with all of your points, and that's why I wanted to add yet another study regarding this ongoing debate. I understand how a patient, if allowed to consume some legumes, might team them with meat, resulting in an even higher level of PO, but I'm sure that a competent renal dietician would make sure that patient understood that legumes are meant to be a substitute for meat. It seems to me that if eating a more plant based diet might be healthier from a cardiovascular point of view, and since CKD/ESRD patients are so much more vulnerable than the general population to heart problems, it might be an idea to further investigate a renal diet that focusses less on meat and more on plants, always being guided by labs, of course.
Every day there seems to be new advice and information about nutrition...a new study, a new concept. It must be difficult to keep up with it all!