When you were first diagnosed with chronic kidney disease one of your first questions may have been ‘What can I do to save my kidneys so I don’t need dialysis?’ Blood pressure control, managing glucose for diabetics and adjustment in dietary protein intake can make a difference in kidney disease progression.
If you eat lots of protein and have CKD, you may want to make a few changes because a high protein diet is hard on your kidneys. On the other hand, a diet too low in protein is even worse for you. When you don’t eat enough protein, your muscles begin to break down. A blood protein called albumin begins to fall. People starting dialysis with low albumin levels are more likely to be hospitalized or die within the year of dialysis compared to those with higher albumin levels (4.0 mg/dL or greater is the goal). (1) Following a low protein diet may buy some time before kidney transplant or dialysis is needed, but it may not be worth the increased risk of complications or even death.
Here are some things to consider before changing to a low protein diet:
- Protein is calculated in grams of protein per kilogram of body weight. To change your weight in pounds to kilograms, divide by 2.2. For example, 154 pounds divided by 2.2 equals 70 kg.
- How much protein do you currently eat? Cutting down to the recommended intake 0.8 g/kg (sometimes as low at 0.6 g/kg) may be enough to take some stress off the kidneys and still keep you healthy. Many people easily eat twice this much protein. Extreme protein intake above 2.0 g/kg stresses the kidneys too much.
- The recommendation for 0.8 g/kg is for healthy adults. Your requirements are higher if you have a stress such as trauma, surgery, hospitalization or a chronic disability. Growing children, pregnant women and older people have higher protein needs too.
- Eliminating protein as much as possible is not going to help, that is too extreme. A low protein diet needs to include enough protein to keep you healthy.
- Consider the source of protein. Animal proteins put more stress on the kidney when they are broken down in the body. However, egg whites, milk, yogurt, beans, legumes, nuts/seeds cheese and soy products don’t put as much stress on the kidneys. (2) Chicken, poultry or fish can be incorporated on occasion, but keep the serving to 2 ounces if possible. Working with a dietitian and your doctor can tailor your preferences to your needs.
- Ask for help from a professional. A renal dietitian can assess your protein status and help determine your daily protein and calorie targets.
- Be sure you are eating enough calories. If calories are too low you end up using some of your protein as an energy source. If you are intentionally cutting calories to lose weight, you may need a higher protein level.
- Find recipes for lower protein entrees or vegetarian protein recipes. DaVita.com offers lower protein recipes for chronic kidney disease patients. You can search using the filter CKD non-dialysis.
References:
- Hsiung JT, Kleine CE, Naderi N, Park C, Soohoo M, Moradi H, Rhee CM, Obi Y, Kopple JD, Kovesdy CP, Kalantar-Zadeh K, Streja E. Association of Pre-End-Stage Renal Disease Serum Albumin With Post-End-Stage Renal Disease Outcomes Among Patients Transitioning to Dialysis. J Ren Nutr. 2019 Jul;29(4):310-321. https://pubmed.ncbi.nlm.nih.gov/30642656/. Accessed October 8, 2026.
2. Moore JWhole-Food Low-Protein Plant-Based Nutrition to Prevent or Slow Progression of Chronic Kidney DiseaseJournal of Renal Nutrition, 2020; 31, e1-e4. https://www.jrnjournal.org/action/showPdf?pii=S1051-2276%2820%2930082-0. Accessed October 8, 2026.
