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Nutritional Management Of Chronic Kidney Disease

Nutritional Management of Chronic Kidney Disease

To improve kidney health, The National Kidney Foundation recommends a plant-based diet such as the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet, which is high in fiber and low in saturated fat.

What is the recommended amount of protein intake for kidney disease patients?

 A high protein diet is popular for quick weight loss and is often recommended for people with diabetes. High dietary protein (between 1.2g/kg-2.0kg/day) can cause kidney disease progression, particularly in patients with proteinuria, protein in their urine. It can also lead to the accumulation of nitrogen-containing waste products in advanced kidney disease and lead to symptoms of kidney failure earlier. Based on data from current research, the recommended protein intake is 0.6-0.8g/kg of body weight per day in patients with moderate to advanced kidney disease and for the management of proteinuria.

Is there a difference in plant versus animal sources of protein?

Yes, there is. Consuming red meat and highly processed meat is associated with an increased risk of proteinuria and a faster decline in kidney function. Alternatively, consuming plant-based protein such as legumes is associated with a reduced risk of kidney disease progression.  Substituting one serving of red meat with a plant-based protein such as legumes has been shown to reduce the risk of chronic kidney disease. You can get more information about plant-based nutrition and kidney disease on kidney.org. Tips and recipes are also available on MeatlessMonday.com.

What is the recommended sodium intake for kidney disease patients?

Sodium intake should not exceed 4 grams per day in patients with mild to moderate kidney disease. Up to 90% of sodium consumed is from processed food such as cereal, canned goods, etc, and only a small fraction of daily sodium intake is from table salt. The best way to decrease sodium in your diet is to avoid packaged and canned goods. 

In summary, diet is very important in the maintenance of kidney health. The diet recommended by your nephrologist will vary depending on the severity of kidney disease as well as specific laboratory values.

Please check with your provider prior to starting any particular diet.

References:

Kasiske BL et al.  A meta-analysis of the effects of dietary protein restriction on the rate of decline in renal function. Am J Kidney Dis 1998:31:954-61

Haring B et al. Dietary protein sources and risk for incident chronic kidney disease: results from the Atherosclerosis Risk in Communities (ARIC) Study  J Ten Nutr 2017;27:233-42

Weiner ID et al.  Urea and ammonia metabolism and the control of renal nitrogen excretion.  Clin J Am Soc Nephrol 2015; 10:1444-58

Lew QJ et al. Red meat intake and risk of ESRD. J Am Soc Nephrol 28: 304-312, 2017

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