What is the recommended protein intake for patients with proteinuria (excess protein in the urine)?

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Last updated: May 5, 2025 • View editorial policy

From the Guidelines

For patients with proteinuria, the recommended protein intake is 0.8 g/kg body weight per day, as this level has been shown to slow GFR decline and reduce the risk of cardiovascular mortality 1. This recommendation is based on the most recent and highest quality study, which suggests that higher levels of dietary protein intake (>20% of daily calories from protein or >1.3 g/kg/day) should be avoided due to their association with increased albuminuria, more rapid kidney function loss, and CVD mortality.

Key Considerations

  • The recommended daily allowance of 0.8 g/kg body weight per day is considered the optimal level of protein intake for patients with non-dialysis-dependent CKD, as it slows GFR decline without causing malnutrition 1.
  • Reducing dietary protein below the recommended daily allowance is not recommended, as it does not alter blood glucose levels, cardiovascular risk measures, or the course of GFR decline 1.
  • Patients should focus on high-quality protein sources, such as lean meats, fish, eggs, and plant proteins, while maintaining adequate caloric intake from carbohydrates and healthy fats to prevent muscle wasting.
  • Regular monitoring of nutritional status, kidney function, and proteinuria levels is essential to adjust recommendations as needed.

Additional Recommendations

  • Restriction of dietary sodium to <2,300 mg/day may be useful to manage blood pressure and reduce cardiovascular risk 1.
  • Individualization of dietary potassium may be necessary to manage serum potassium concentrations, particularly for individuals with reduced eGFR 1.
  • For individuals on dialysis, higher levels of dietary protein intake (1.0-1.2 g/kg/day) should be considered to prevent protein-energy wasting 2.

From the Research

Guideline for Protein Intake in Patients with Proteinuria

  • The recommended protein intake for patients with chronic kidney disease (CKD) is 0.6 to 0.8 grams per kilogram of body weight per day (g/kg/day) 3.
  • A low-protein diet can reduce proteinuria, especially in non-diabetic CKD patients, and may lead to an increase in serum albumin level in hypoalbuminemic patients 3, 4.
  • Protein intake should be reduced progressively based on the severity and progression of CKD and the patient's nutritional status, with a target of 0.6-0.8 g/kg/d in most patients with estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2 3.
  • A dietary protein intake below 1.0 g/kg/day is suggested when eGFR falls below 60 mL/min/1.73 m2 or when there is solitary kidney or proteinuria at any level of GFR 3.
  • The risk of protein-energy wasting can be overcome by careful attention to the quantity and quality of ingested proteins, sufficient energy intake, and the use of dietary supplements 3.

Protein Restriction and Nutrition Therapy

  • Protein restriction is the main dietary intervention for managing proteinuria, and medical nutrition therapy is imperative for patients with proteinuria 5.
  • A low-protein diet can slow the progression of renal disease by reducing proteinuria, decreasing nitrogen waste products, and ameliorating metabolic burden 3, 4, 6.
  • The association of a low-protein diet with ACE inhibitors or sartans has an antiproteinuric effect stronger than that of a low-protein diet or antihypertensives alone 4.

General Protein Intake Recommendations

  • The Recommended Dietary Allowance of protein for a healthy adult with minimal physical activity is 0.8 g protein per kg body weight per day 7.
  • Long-term consumption of protein at 2 g per kg body weight per day is safe for healthy adults, and the tolerable upper limit is 3.5 g per kg body weight per day for well-adapted subjects 7.
  • Chronic high protein intake (>2 g per kg body weight per day for adults) may result in digestive, renal, and vascular abnormalities and should be avoided 7.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Low-protein diet and proteinuria].

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2008

Research

Diet and Proteinuria: State of Art.

International journal of molecular sciences, 2022

Research

Dietary protein intake and human health.

Food & function, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.