The two best reasons NOT to focus on protein restriction in chronic kidney disease

2007 ◽  
Vol 3 (10) ◽  
pp. E1-E1 ◽  
Author(s):  
John W Graves
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Protein Restriction

scholarly journals Optimal Protein Intake in Pre-Dialysis Chronic Kidney Disease Patients with Sarcopenia: An Overview

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1205
Author(s):  
Yoshitaka Isaka
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Exercise Therapy ◽  
Protein Intake ◽  
Renin Angiotensin System ◽  
Protein Restriction ◽  
Ckd Stage ◽  
End Stage

Multi-factors, such as anorexia, activation of renin-angiotensin system, inflammation, and metabolic acidosis, contribute to malnutrition in chronic kidney disease (CKD) patients. Most of these factors, contributing to the progression of malnutrition, worsen as CKD progresses. Protein restriction, used as a treatment for CKD, can reduce the risk of CKD progression, but may worsen the sarcopenia, a syndrome characterized by a progressive and systemic loss of muscle mass and strength. The concomitant rate of sarcopenia is higher in CKD patients than in the general population. Sarcopenia is also associated with mortality risk in CKD patients. Thus, it is important to determine whether protein restriction should be continued or loosened in CKD patients with sarcopenia. We may prioritize protein restriction in CKD patients with a high risk of end-stage kidney disease (ESKD), classified to stage G4 to G5, but may loosen protein restriction in ESKD-low risk CKD stage G3 patients with proteinuria <0.5 g/day, and rate of eGFR decline <3.0 mL/min/1.73 m2/year. However, the effect of increasing protein intake alone without exercise therapy may be limited in CKD patients with sarcopenia. The combination of exercise therapy and increased protein intake is effective in improving muscle mass and strength in CKD patients with sarcopenia. In the case of loosening protein restriction, it is safe to avoid protein intake of more than 1.5 g/kgBW/day. In CKD patients with high risk in ESKD, 0.8 g/kgBW/day may be a critical point of protein intake.

Light and shadows of dietary protein restriction in elderly with Chronic Kidney Disease

Nutrition ◽  
2013 ◽  
Vol 29 (9) ◽  
pp. 1090-1093 ◽  
Author(s):  
Mauro Giordano ◽  
Tiziana Ciarambino ◽  
Pietro Castellino ◽  
Giuseppe Paolisso
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dietary Protein ◽  
Protein Restriction ◽  
Dietary Protein Restriction

Positive Effects of Protein Restriction in Patients With Chronic Kidney Disease

2008 ◽  
Vol 18 (3) ◽  
pp. 269-280 ◽  
Author(s):  
Sintra Eyre ◽  
Per-Ola Attman ◽  
Börje Haraldsson
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Protein Restriction ◽  
Positive Effects
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