Dietary protein intake and chronic kidney disease

Gang Jee Ko, Yoshitsugu Obi, Amanda R. Tortorici, Kamyar Kalantar-Zadeh

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Purpose of review High-protein intake may lead to increased intraglomerular pressure and glomerular hyperfiltration. This can cause damage to glomerular structure leading to or aggravating chronic kidney disease (CKD). Hence, a low-protein diet (LPD) of 0.6-0.8 g/kg/day is often recommended for the management of CKD. We reviewed the effect of protein intake on incidence and progression of CKD and the role of LPD in the CKD management. Recent findings Actual dietary protein consumption in CKD patients remains substantially higher than the recommendations for LPD. Notwithstanding the inconclusive results of the 'Modification of Diet in Renal Disease' (MDRD) study, the largest randomized controlled trial to examine protein restriction in CKD, several prior and subsequent studies and meta-analyses appear to support the role of LPD on retarding progression of CKD and delaying initiation of maintenance dialysis therapy. LPD can also be used to control metabolic derangements in CKD. Supplemented LPD with essential amino acids or their ketoanalogs may be used for incremental transition to dialysis especially on nondialysis days. The LPD management in lieu of dialysis therapy can reduce costs, enhance psychological adaptation, and preserve residual renal function upon transition to dialysis. Adherence and adequate protein and energy intake should be ensured to avoid protein-energy wasting. Summary A balanced and individualized dietary approach based on LPD should be elaborated with periodic dietitian counseling and surveillance to optimize management of CKD, to assure adequate protein and energy intake, and to avoid or correct protein-energy wasting.

Original languageEnglish
Pages (from-to)77-85
Number of pages9
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume20
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Dietary Proteins
Protein-Restricted Diet
Chronic Renal Insufficiency
Dialysis
Proteins
Energy Intake
Diet Therapy
Kidney
Essential Amino Acids
Nutritionists
Psychological Adaptation
Disease Management
Meta-Analysis
Counseling
Randomized Controlled Trials
Maintenance
Pressure
Costs and Cost Analysis
Incidence
Therapeutics

Keywords

  • glomerular hyperfiltration
  • incremental hemodialysis
  • low-protein diet
  • progression of chronic kidney disease
  • protein-energy wasting

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Dietary protein intake and chronic kidney disease. / Ko, Gang Jee; Obi, Yoshitsugu; Tortorici, Amanda R.; Kalantar-Zadeh, Kamyar.

In: Current Opinion in Clinical Nutrition and Metabolic Care, Vol. 20, No. 1, 01.01.2017, p. 77-85.

Research output: Contribution to journalReview article

Ko, Gang Jee ; Obi, Yoshitsugu ; Tortorici, Amanda R. ; Kalantar-Zadeh, Kamyar. / Dietary protein intake and chronic kidney disease. In: Current Opinion in Clinical Nutrition and Metabolic Care. 2017 ; Vol. 20, No. 1. pp. 77-85.
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