Is A Low Protein Diet The Answer
Even though it makes intuitive sense, and even though excess protein in the urine is directly associated with hyperfiltration, at this time the effect of protein restriction on renal function is uncertain. For now, suffice it to say that a moderate protein diet with about 0.8 grams per kilo body weight of protein per day, might be beneficial but going on a low protein diet may not be of benefit.
Concerns Over Low Protein Diets
One of the concerns when someone is following a low protein diet and particularly a very low protein diet is protein energy malnutrition which occurs when youre not getting enough protein for your bodys demand. I spoke earlier about the many important roles that protein plays in the body so it makes sense that problems can arise when we get less than our body needs to function.
Maintaining adequate energy intake is necessary to prevent protein energy malnutrition and evidence from studies indicates that energy intake ranging from 30 to 35 kcal per kg per day prevents protein energy malnutrition in people following a low protein diet.
I just wanted to highlight that the type of protein you consume is also important, not just the amount. It is well established that following a primarily plant-based diet is protective to the kidneys and can help prevent the development and progression of CKD so most of your protein should be coming from vegetarian sources and if eating animal protein choose chicken, fish, seafood or eggs.
So there you go, a deep dive into all things protein and kidney disease. If youve found this article useful, Id really appreciate it if you let me know by clicking the SHARE button below and feel free to share it with family and friends.
Foods To Avoid On A Low Protein Diet
Foods highest in protein tend to come from animal meats. So when we talk about a plant-based diet for kidney disease, this really fits the bill!
Additionally, high-protein plant foods such as tofu, legumes and beans may need to be limited as well. Its not just about the source of protein in your diet its the quantity.
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Historical Background Of Low
Dietary protein restriction is the mainstay of the nutritional therapy for CKD. Since the 19th century it had been realized that uremic syndrome derives from the retention of molecules and toxins resulting from the catabolism of exogenous proteins, usually excreted with the urine. However, it was only in the 1960s, that Giovannetti and Maggiore suggested the low-protein diet as a therapy for advanced CKD . At that time dialysis was still in the experimental stage and only a small number of patients could benefit. A protein restricted diet providing adequate amounts of aminoacids and energy supply was therefore the only widespread means to alleviate uremic symptoms and to prolong survival .
It is noteworthy that urea reduction is not the only aim of the low protein diet. Indeed, in the early 1980s Maschio and Barsotti highlighted the importance of protein restriction in the reduction of phosphorus intake in moderate to advanced CKD . This aspect, neglected for many years, now enjoys significant renewed interest stimulated by the evidence of the key role of phosphorus retention in the pathogenesis of the so-called CKD-MBD and in the progression of renal disease .
Dietary sodium restriction is another aspect of the nutritional therapy for CKD, as it allows better management of sodium and water retention, blood pressure control, and reduction of proteinuria .
Best Sources Of Protein For Kidney Disease
Interestingly, not all proteins are created equal. As you may have read in an earlier article of mine, there is plenty of research proving that chicken meat for example, is a much better protein source than red meat for kidney disease. Research has proven that switching to chicken, over red meat, is just as effective as using blood pressure lowering medication blood pressure lowering medication is a common medication in the management of kidney disease. If you missed this article, you can find it here: Kidney Problems: Chickens To The Rescue?
But it is not just chicken that is an excellent source of protein for kidney disease, here are others that are known to be beneficial for kidney damage: chicken, turkey, tofu, tempeh, fish, crustaceans, beans, lentils, buckwheat, brown rice, oats, and nuts and seeds just to name a few .
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Effect Of Low Protein Diet On Metabolic Control
LPD is beneficial to improve metabolic acidosis in CKD. Acid is generated during metabolism of proteins including sulfur containing amino-acids, and pre-dialysis serum bicarbonate concentration was lower in patients with higher protein intake. There is a tendency toward acid retention with kidney function declines and resultant chronic metabolic acidosis in CKD impairs protein metabolism, increases muscle catabolism and wasting, and aggravates decline in renal function and uremic symptoms. Indeed, LPD ameliorated metabolic acidosis among patients with advanced CKD. In a study of supplemented VLPD, mean serum bicarbonate levels remained < 19 mmol/L in the control group while it increased to the normal levels in the VLPD group. Interestingly, a RCT of correcting metabolic acidosis with sodium bicarbonate supplementation among patients with stage 4 CKD showed that after 2 years of study period, participants in the intervention group experienced slower decline in kidney function, much lower incidence of ESRD, and improvements in nutritional status although they increased dietary protein intake.
How Do Doctors Treat Protein In The Urine
Doctors treat the cause of protein in the urine:
- If you have diabetes, your doctor will help create a treatment plan to keep it under control and slow down damage to your kidneys. They may recommend that you:
- Check your blood sugar often
- Take certain medicines
- Follow a diabetes-friendly eating plan
- Be active most days of the week
- If you have high blood pressure, your doctor may prescribe a medicine to help lower your blood pressure and slow down damage to your kidneys. The types of medicine are:
- Angiotensin-converting enzyme inhibitors, which are a group of medicines that lower blood pressure. They widen your blood vessels, help your kidneys get rid of extra water and lower the hormones that raise blood pressure.
- Angiotensin receptor blockers , which are a group of medicines that lower blood pressure. They widen your blood vessels.
- If you do not have diabetes or high blood pressure, your doctor may still prescribe an ACE inhibitor or an ARB to slow down damage to your kidneys.
Drinking water will not treat the cause of protein in your urine unless you are dehydrated. Drinking water will dilute your urine , but will not stop the cause of your kidneys leaking protein.If you have protein in your urine, talk with your doctor to choose the best treatment option for you.
How Is A Kidney
When your kidneys are not working as well as they should, waste and fluid build up in your body. Over time, the waste and extra fluid can cause heart, bone and other health problems. A kidney-friendly meal plan limits how much of certain minerals and fluid you eat and drink. This can help keep the waste and fluid from building up and causing problems.
How strict your meal plan should be depends on your stage of kidney disease. In the early stages of kidney disease, you may have little or no limits on what you eat and drink. As your kidney disease gets worse, your doctor may recommend that you limit:
Why Is Limiting Protein Important For People With Ckd
When your body uses protein, it produces waste. This waste is removed by the kidneys. Too much protein can make the kidneys work harder, so people with CKD may need to eat less protein.
For patients with estimated glomerular filtration rate 60 mL/min who do not have nephrotic syndrome , we suggest restricting daily protein intake to 0.8 g/kg. Nutritional fstudies in patients with reduced eGFR suggest that protein intake can be safely lowered to 0.6 g/kg per day. A modest restriction is generally well tolerated and does not lead to malnutrition in patients with CKD providing caloric goals are met, dietary protein is of high biologic value, and metabolic acidosis is avoided. Patients should be discussing that in depth with their treating physician.
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.
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Will I Need To Limit Fluid
Most people in the early stages of kidney disease do not need to limit the amount of fluids they drink. If you do not know your stage of kidney disease, ask your healthcare provider.
If your kidney disease gets worse, your dietitian or healthcare provider can let you know if you need to limit fluids and how much to drink each day.
How Much Protein Do I Need
Protein needs are very different based on what stage of kidney disease you have.
In general, people who have kidney disease stages 1-3a should avoid high protein diets. If kidney disease progresses to stages 3b-5, a low protein diet is ideal. If kidney disease progresses further and dialysis is needed, you actually need a HIGH protein diet.
Protein needs are also different based on your medical and nutrition history. Ask your dietitian exactly how much protein is right for you.
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Conservative Management With Low Protein Diet In End
Less accumulation of protein waste products relieves clinical manifestations of uremia even in very late stage of CKD, and indeed LPD can be used effectively to delay the initiation of dialysis therapy. Given that earlier dialysis initiation does not appear to offer any survival benefit, conservative approaches are warranted in managing patients with advanced CKD.
How Can You Protect Your Kidneys And Lose Weight Too
For weight loss that wont compromise your kidneys, its all about balance.
Dont get your calories from one source combine protein with more fruits and vegetables, Dr. Calle recommends. If you dont have any major medical conditions, the most effective diet is usually decreasing the amount of calories you consume and eating a more balanced, low-sodium diet.
Andbuyer beware when it comes to the healthfadsthat show up on social media. Your favorite Instagram celebrity may lookamazing after following some new grapefruit shake diet, but stick with yourdoctor, nutritionist or dietitian for reliable eating advice.
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How Much Protein Should You Be Eating Per Day
In recent years, many people have begun to increase their protein intake in an effort to aid weight loss and/or build muscle, but how much protein should you be eating every day?
Though the ideal amount of protein you should be consuming is slightly uncertain – the most common recommendation is 0.8 grams of protein per kilogram of body weight. So if you weighed 60kg, youd need about 48g per day.
Before starting a new diet plan, its important to seek medical advice and speak with your healthcare provider.
If youre concerned about your kidney health, its important to make a trip to the doctor for a check-up.
If you want to know more about your kidney health, including your kidney function and its performance, you can take an at-home Kidney Test with LetsGetChecked. This test will indicate how your kidneys are performing by measuring levels of urea, creatinine, and eGFR. High levels of urea, creatinine and a low eGFR can indicate acute or chronic kidney disease.
You should take the test if:
- You have a high protein diet
- You have used or are using performance-enhancing drugs
- You are taking anti-inflammatory medication
- You suffer from high blood pressure
- You suffer from diabetes
- You have suffered an acute injury
- You have persistent urinary tract infections
- You have a kidney disease or a family history of one
- You have kidney stones or a family history of them
What Is A Low Protein Diet
A low protein diet is a diet in which the daily protein allowance is restricted below the general nutrition guidelines.
The general recommendation for adequate protein is 0.8 grams of protein per kilogram of body weight.
A low protein diet is anywhere from 0.6 to 0.8 grams of protein per kilogram of body weight. The specific amount determined in this range will include factors such as age, activity level, stage, and cause of kidney disease.
Fat and carbohydrates will need to be adjusted when on a low protein diet. Fat and carbohydrates are the other to macronutrients in our diet.
And while Im not a fan of the traditional ketogenic diet, I do believe that a modified version can be very beneficial. Read more about the keto diet and kidney disease here.
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Other Protein Powder Side Effects
Kidney issues may not be a huge concern with protein drinks, but if you overdo it on the protein supplements or whey protein, side effects that have nothing to do with your kidneys are possible. According to Harvard Health Publishing, eating too much protein may set you up for:
- High cholesterol
- Increased risk of heart disease
- Weight gain
- Constipation and/or diarrhea
However, Harvard Health also notes that these effects may not be caused by the protein directly, but may be connected to eating the wrong types of protein, like a lot of processed meats, that are also higher in unhealthy fats and artificial ingredients.
How To Reduce Protein In Urine
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, several readers have written to tell us that this article was helpful to them, earning it our reader-approved status. This article has been viewed 218,664 times.
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The Best Low Phosphorus Proteins For Kidney Disease
Ultimately, the best low phosphorus proteins for kidney disease are plant proteins. Because most phosphorus in plant foods is not absorbed, plant proteins are the best low phosphorus protein!
Here are some of my favorite plant proteins for people with kidney disease:
- Whole grains
- Green peas
As always, a healthy diet for kidney disease must be individualized to YOU based on your lab results and medical history. Ask your dietitian how to healthfully eat these plant proteins!
Should Everyone Avoid A High
Dr.Calle advises patients with chronic kidney disease to take the better safethan sorry route. They probably should limit protein, he says.
His advice also applies to people who have a history of kidney stones or certain rare genetic conditions like phenylketonuria . That can put them at higher risk of forming kidney stones, which may potentially affect their kidney function, too.
But even if your kidneys seem to be firing on all cylinders, its still a good idea to check with a doctor before making any drastic changes to what you eat. Diets arent one-size-fits-all. A doctor can help you find an eating plan thats appropriate for your health goals.
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How Your Kidneys Work
To grasp why protein would have an effect on your kidneys, it’s helpful to understand how your kidneys actually work. Your kidneys, which are located just below your rib cage on each side of your spine, are one of your body’s major filtration organs. Their main job is to filter wastes and any extra fluid out of your blood and then out of your body, through your urine. Your kidneys also filter metabolic byproducts, like acid, to maintain the proper balance of water, salt and electrolytes.
All of your blood passes through tiny filtration vessels called nephrons, which filter your blood, removing the waste products and returning any necessary nutrients to it. When your kidneys are healthy, they remove waste and extra fluid out of the blood, but allow protein to stay. On the other hand, if your kidneys aren’t working properly, some of the protein in your blood can make its way into the nephrons and, eventually, into your urine.
How Much Protein Should I Be Eating
So, the next obvious question is- how much protein should I be eating if I have kidney disease? The following recommendations come from the 2020 Kidney Disease Outcomes Quality Initiative nutrition guidelines.
Stages 1 & 2 CKD
Protein: 0.8 grams protein per kg of body weight
Stages 3 to 5 CKD without diabetes
Low Protein Diet: 0.55 grams to 0.60 grams protein per kg of body weight
Very Low Protein Diet: 0.28 grams to 0.43 grams protein per kg of body weight
* When a very low protein diet is followed this must include keto acid/amino acid analogs to meet protein requirements and only be undertaken under close clinical supervision*
Very low protein diets typically are only recommended to people in stages 4 & 5 of CKD
Stages 3 to 5 CKD with diabetes
Protein: 0.60 grams to 0.8 grams protein per kg of body weight
Stage 5 CKD on dialysis
Protein: 1.0 grams to 1.2 grams protein per kg of body weight
These amounts are guidelines only and actual protein requirements may differ from person to person so its important to discuss your own protein requirements with your doctor, dietitian or naturopath. These recommendations are for people who are metabolically stable which means the absence of any active inflammatory or infectious diseases, without poorly controlled diabetes, absence of diseases like cancer and without significant short-term weight loss.
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