Eleven reasons to control the protein intake of patients with chronic kidney disease
Abstract
For many years patients with chronic kidney disease have been advised to control the protein content of their diet. This advice has been given on the basis of a number of reported metabolic effects of lowering protein intake, such as lowering serum urea nitrogen levels, improving phosphocalcic metabolism and insulin resistance and, more recently, ameliorating proteinuria (independent of antiproteinuric medications). The effects on the progression of kidney disease, although spectacular in experimental studies, have been less convincing in humans. It is possible that flawed design of clinical trials is responsible for this discrepancy. In this Review, we comment on experimental findings that indicate that limiting protein intake protects the kidney and ameliorates uremic symptoms, outline how the body adapts to a reduction in protein intake, and describe the metabolic benefits to the patient. We then review the evidence from randomized controlled trials and meta-analyses that pertains to the effects of low-protein diets in adults with chronic kidney disease.
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Compared with a non-protein-limited diet, a low-protein diet of 0.6 g/kg BW/d can prevent a decline in GFR of approximately 1 mL/min per year per 1.73 m2 and is associated with a 30% decrease in reaching a dialysis-dependent stage.
“Compared with a noneproteinlimited diet, a low-protein diet of 0.6 g/kg BW/d can prevent a decline in GFR of approximately 1 mL/min per year per 1.73 m 2 and is associated with a 30% decrease in reaching a dialysisdependent stage.114,115”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [114]
In patients with nondiabetic CKD stages 3 and 4 (moderate to severe) up to age 70, there is evidence that low-protein diets can slow the progression of CKD.
“In patients with nondiabetic CKD stages 3 and 4 (moderate to severe) up to age 70, there is evidence that low-protein diets can slow the progression of CKD.112e114”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [114]
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- Authors
- Fouque, D., & Aparicio, M.
- Affiliations
- Lyon 1 Université (FR)
- Université de Bordeaux (FR)
- Corresponding author
- Fouque, Denis
- ORCID
- Fouque, Denis
- Venue
- Nature Clinical Practice Nephrology
- Published
- 2007-07
- Volume
- 3
- Issue
- 7
- Pages
- 383-392
- ISSN
- 1745-8323 (ISSN-L)
- 1745-8331
- OpenAlex
- W2016151019
- Cited by
- 152
- References
- 98
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 8 · 2023: 3 · 2022: 11 · 2021: 16 · 2020: 12 · 2019: 7 · 2018: 10 · 2017: 4 · 2016: 9 · 2015: 6 · 2014: 17 · 2013: 11 · 2012: 7
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Reviews Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Keywords
- chronic kidney disease, low-protein diet, protein intake, uremic symptoms, proteinuria, blood urea nitrogen, phosphocalcic metabolism, insulin resistance, kidney disease progression
- MeSH terms
- Energy Metabolism, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic, Kidney Function Tests, Male, Nutritional Requirements, Risk Factors, Severity of Illness Index, Randomized Controlled Trials as Topic, Treatment Outcome, Disease Progression, Diet, Protein-Restricted
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