“What should I eat?” is the most frequently-asked question to dietitians from people with chronic kidney disease (CKD). The renal diet can appear to be very confusing. I had kidney failure back in the late 1980s and became a registered dietician (RD) in 1993. I have been a vegetarian for the past 25 years, and have had a transplant for 15 years. So I understand the struggle. I have found that the more I learn, the easier it gets. Food is something we can control and it can make a huge difference for our health.
Renal diets are based on kidney function. The primary components of a renal diet which need to be monitored are protein, salt, potassium, and phosphorus. Hopefully, the following will address the general dietary requirements of protein for people with CKD. Protein requirements for people who have kidney disease may vary over time.
Why is Protein Important? Protein is an essential nutrient for the body as it plays a crucial role in numerous bodily functions. It is the building block for cells, tissues, and organs, and is involved in vital processes such as muscle repair, hormone production, neurotransmitter synthesis, and immune system function.
Your kidneys are your body’s filters. When you have any stage of CKD, your kidneys are less and less able to rid the body of nitrogenous protein waste from food and beverages. This waste then starts to accumulate in the bloodstream, which is called uremia. Symptoms of uremia include nausea, bad taste in the mouth, loss of appetite, and weakness.
CKD and Post-Transplant Protein Intake To maintain kidney health, it is important for individuals with CKD to consume enough protein from the right sources without overburdening the kidneys. Consuming excessive protein can lead to the accumulation of waste products in the blood, worsening the condition. A reduced protein intake can help to decrease the progression of kidney disease.
Types of Proteins There are two types of protein: protein from animals, and protein from plants.
- Sources of animal protein include fish, chicken, eggs, shellfish, and dairy products.
- Sources of plant protein include beans, legumes, soy, and tofu.
- Protein powder supplements are often made of whey and are not advised for low-protein diets, unless they are from plant sources such as peas.
CKD Stages 3-5 Unfortunately, as the disease progresses to CKD stages 3-5 (GFR 59 or lower) you will need to reduce your protein intake considerably. According to recent studies, maintaining protein intake to 0.55–0.60 grams per kilogram of body weight can postpone the deterioration of kidney function. For instance, if you weigh 68 kg (150 lbs), your daily protein requirement is 40 grams (68 x 0.6 g/kg). This is roughly equivalent to 4-6 ounces of plant- or animal-based protein each day. It is preferable to consume more plant-based protein when your glomerular filtration rate (GFR) begins to drop since plant protein digests more slowly than animal protein. You may determine the ideal kind and quantity of protein for you with the assistance of a renal dietitian.
In order to prevent malnutrition, a doctor may occasionally recommend keto acid analogs to supplement a very low-protein diet. Grains and starchy foods provide limited amounts of protein, so that must also be taken into consideration.
Even though you are eating less protein, you still need to eat enough calories from other food groups to prevent weight loss and muscle wasting. There are other dietary factors to be familiar with in addition to limiting protein, depending on if you also have diabetes, high blood pressure, or hyperlipidemia.
Limiting protein could sound challenging and perhaps unattainable. However, a renal dietitian can help you plan out a diet that will work for your preferences and your lifestyle.
When on Dialysis, Everything Changes When undergoing dialysis treatments, protein intake becomes even more crucial as the dialysis process can result in protein loss. The recommended protein intake for individuals on dialysis varies depending on factors like weight, age, and overall health. Insufficient protein levels can lead to muscle loss, weight loss, hair loss, fatigue, increased susceptibility to infections, edema, longer hospital stays, and a higher risk of heart disease. Generally, people on dialysis are advised to consume a higher amount of protein compared to individuals with normal kidney function.
You can tell if you are eating enough protein by looking at your albumin level on lab tests. A normal albumin level is 3.8 to 5.0 g/dL.
To stay strong and healthy, check your lab values, talk to your renal dietician, and eat the right amount of protein for your body.
Lubna Akbany, RD, CSR, is a registered dietitian nutritionist and certified specialist in renal nutrition with over 20 years of experience. She specializes in CKD management and diabetes, focused on CKD nutrition. Lubna is a mom, a kidney transplant recipient, and an effective nutrition communicator. Lubna’s goal is to empower people to slow down the progression of kidney disease with proven nutrition and supplement interventions. She quotes, “If I can give you more confidence in your diet, help you keep your kidneys, and give you more time to enjoy your life the way you want, I’ll have done my job.”
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