Protein Intake in Chronic Kidney Disease

The purpose of this review is to better understand the protein needs in patients with chronic kidney disease (CKD) not on dialysis. Protein energy wasting is common in patients with chronic kidney disease, and the incidence increases as the kidney function declines. Typically, protein intake in patients with CKD is lower than the daily-recommended allowance for healthy adults, and that poor nutritional status has been associated with increase in morbidity and mortality. It is of interest to note that the current guidelines for protein intake vary in terms of both quantity as well as the quality, thus making it confusing for the practicing nephrologist.

Recent studies show that very low protein intake when supplemented by keto-analogues of essential amino acid could be helpful in slowing the progression of chronic kidney disease. However, it is important to understand that recommending low protein intake could be harmful in CKD patients especially those with poor nutritional status or during an acute illness.

In summary, it is important for the physician to understand that patients with chronic kidney disease have very complex nutritional requirements, and that recommendations for protein intake should be based on the individual patient needs.