Trying to sort out the facts behind protein intake and CKD

[ILMA54]

I am in Stage 5 CKD (GFR of 15). For about one year, I have been on the edge of malnutrition (ALB <= 3.4). As a result my nephrologist has been pushing proteitn (1 g/kg body weight per day). In addition, I was told during my dialysis orientation (not on dialysis yet() that when I start peritoneal dialysis. they will ask me to consume 1.3 g/kg weight per day.

I see a number of people advocating plant based diets,. so I asked my nephrologist about this. He said, as others have done, that protein is indeed hard for the kidneys to process, but because of my borderline albumin, that course of action would be very harmful because if and when I start dialysis., it will be hard enough to keep ALB up, leading to fatigue and muscle loss.

I trust my nephrologist implicitly, but I am confused why those of you on a plant based diet are not concerned about minimizing protein (or animal-based protein). Perhaps you do not have low Albumin.

As they say, the devil is in the details.

Thanks in advance.

[Bassetmommer NKF Ambassador]

HI ILMA,

The nephrologist is steering you in the direction you need to go for you. Many of us who eat plant based foods have different situations. I have a higher GFR. My nephrologist and renal dietician all support plant based diets for the health of the kidney. For me, I try to get my protein level up as recommended by the dietician, but I don't always make it. But I eat cheese and eggs. I do not eat beans and other legumes that are high in protein because of the potassium in them. But I would if I could for protein. My labs show I am in a normal range for protein and albumin.

I know that protein needs change with stages of CKD and especially on dialysis.

nephron.org/nephsites/adp/p...

[RonaldoResuelto]

It can certainly be difficult to get sufficient protein on a plant based diet. Those of us who choose that route usually have a fairly high GFR, and many of us take protein supplements. I supplement with a plant based protein powder because I believe plant protein is easier on the kidneys. In your situation, it sounds to me like your doctor is right on track. He is trying to keep you healthy. It's a balancing act.