From the Guidelines
Increased protein intake should be avoided in patients with chronic kidney disease (CKD) as it can lead to increased albuminuria, more rapid kidney function loss, and cardiovascular disease (CVD) mortality, with a recommended daily intake of 0.8 g/kg body weight per day 1. When considering the impact of protein intake on glomerular filtration rate (GFR), it is essential to understand the mechanisms by which the kidneys respond to increased protein consumption.
- The kidneys increase their filtration rate to handle the additional metabolic waste products generated by dietary proteins, particularly animal proteins.
- This increase in filtration rate can lead to hyperfiltration, potentially stressing the kidneys and accelerating kidney function loss.
- The evidence suggests that higher levels of dietary protein intake (>20% of daily calories from protein or >1.3 g/kg/day) should be avoided in patients with CKD, as they are associated with increased albuminuria, more rapid kidney function loss, and CVD mortality 1.
- In contrast, reducing dietary protein intake to 0.8 g/kg body weight per day can slow GFR decline, with evidence of a greater effect over time 1.
- It is also important to note that individualization of dietary sodium and potassium intake may be necessary to manage serum potassium concentrations and blood pressure, particularly in patients with reduced eGFR 1.