From the Guidelines
Plant-based protein is generally safer than meat protein for patients with Chronic Kidney Disease (CKD). For most CKD patients, shifting toward more plant proteins like legumes, whole grains, nuts, and soy products can help manage the disease better than animal proteins. According to the 2025 KDOQI US commentary on the KDIGO 2024 clinical practice guideline for the evaluation and management of CKD 1, advising people with CKD to adopt healthy and diverse diets with a higher consumption of plant-based foods compared to animal-based foods is recommended.
Key Considerations
- Plant proteins typically produce fewer waste products like urea and phosphorus that the damaged kidneys must filter, reducing the overall kidney workload.
- They also tend to be lower in phosphorus and potassium, which CKD patients often need to restrict.
- Additionally, plant proteins usually come with less dietary acid load, which helps prevent metabolic acidosis common in kidney disease.
- The recommended protein intake for adults with CKD G3–G5 is 0.8 g/kg body weight/d, as suggested by the KDOQI US commentary 1.
- Growing evidence suggests that higher plant protein intake and replacement of animal protein with plant protein is associated with lower risk of all-cause and cardiovascular mortality, as reported in the 2025 standards of care in diabetes 1.
Personalized Nutrition Plan
However, protein needs are highly individual in CKD, and the appropriate amount depends on the disease stage, whether the patient is on dialysis, and other health factors. Most pre-dialysis CKD patients should consume about 0.6-0.8 grams of protein per kilogram of body weight daily, with at least 50% coming from plant sources. Patients should work with a renal dietitian to create a personalized eating plan that balances adequate nutrition with kidney protection, as some plant foods (like certain nuts and beans) can be high in potassium or phosphorus.
From the Research
Comparison of Plant-Based and Meat Protein for CKD Patients
- Plant-based protein has been shown to be safer and more beneficial for patients with Chronic Kidney Disease (CKD) compared to meat protein 2, 3, 4, 5, 6.
- A diet containing 70% protein from plants has been found to be safe, tolerated, and efficacious in lowering urine phosphorus excretion, which is a key concern for CKD patients 2.
- Plant-based protein is less likely to promote an acidic environment, inflammation, and renal hyperfiltration, which are all harmful to CKD patients 3, 4, 5.
- A whole food plant-based (WFPB) diet has been shown to offer benefits that slow the progression of CKD, decrease the incidence of cardiovascular disease, decrease rates of diabetes and obesity, and reduce inflammation and cholesterol 3.
- A plant-dominant low-protein diet (PLADO) has been found to be promising and consistent with precision nutrition, and may lead to favorable alterations in the gut microbiome, which can modulate uremic toxin generation and slow CKD progression 4.
- Red meat intake has been associated with an increased risk of cardiovascular mortality and may lead to an elevated production of uremic toxins, which are harmful to CKD patients 5.
- Plant-based diets have been found to be beneficial for kidney disease prevention, chronic kidney disease incidence and progression, metabolic acidosis, hyperphosphatemia, hypertension, uremic toxins, and patient satisfaction and quality of life 6.
Key Findings
- Plant-based protein is less bioavailable than animal-based protein, which can help reduce the risk of hyperphosphatemia in CKD patients 2.
- A plant-based diet can help reduce the production of uremic toxins, which are associated with increased risk of cardiovascular mortality 3, 4, 5.
- Plant-based diets are associated with a lower risk of kidney disease progression and may help reduce the need for kidney replacement therapy, including dialysis 4, 6.
- Concerns about hyperkalemia and protein inadequacy with plant-based diets may not be as significant as previously thought, and the advantages of plant-based diets for CKD patients are vast 6.