CKD and protein intake

Proteins are essential to life. They provide the building blocks for tissue, hormones, enzymes and other body-friendly compounds and account for 15% of the mass of the human body. Each protein is formed from a chain of multiple amino acids, which are the structural units of the proteins. Different combination of amino acids gives different types of proteins.

  • I am on dialysis. Do I need protein?
  • Indeed, and more than before. It is very important for the food to contain amino acids, which the body cannot make on its own. Some foods high in protein contain all these amino acids (which are necessary) and these are called "complete" or foods of high biological value (BV) or quality. These are egg, meat, fish, poultry, milk, cheese, and so on. Vegetarian proteins (rice, pasta, pulses, vegetables), i.e. proteins of low biological value do not contain all the essential amino acids.
  • If I do not eat a satisfactory amount of protein what will happen?
  • During hemodialysis, we have a loss of proteins. If you do not get enough protein, you will experience hypothermia, structural problems in the muscles and other important functions of the body. There will be severe fatigue, infections and weight loss.
  • I undergo dialysis therapy. How much protein can I consume?
  • Before the dialysis session, it is likely that your nephrologist had limited the amount of protein you are consuming. At the onset of hemodialysis, the amount of protein in the diet increases, because the intake of sufficient quantity of protein is important for the patient’s general health.
  • Which foods are high in protein?
  • Substances containing proteins are fresh meat, chicken, fish, eggs and small quantities of dairy products. There are other foods rich in protein (such as milk, yoghurt, cheese) but they also contain large amounts of phosphorus, and they can be consumed in relatively small quantities. Also, eggs are high in protein, containing most amino acids from other foods. The consumption of one or two eggs per day is a proper dietary regimen. In hyperlipidemia cases (increased cholesterol, elevated triglycerides), it is best to eat only the egg white.
  • I am on dialysis. How many calories should I eat per day?
  • An average person with an ideal body weight who does not work needs to eat daily 30-50 calories/kg of body weight, i.e. a 70 kg person needs 2100 calories/day. The dialysis patient should receive about 35-40 Kcal/kg body weight (per kilogram of body weight). This means that if the calories he gets is less than normal then he is going to lose weight since his body begins to burn out its own tissues. Of course, those who work hard need to consume more calories. Note that in addition to the calories in nutrition, when someone undergoes dialysis therapy and the solution contains glucose of 200 mg/dl, then he earns at each dialysis 400 calories from the glucose of the solution he takes.
  • Mesogeios Dialysis Centers Group Scientific Team 
  • Bibliography 
  • 1.Obi Y, Qader H, Kovesdy CP, Kalantar-Zadeh K. Latest consensus and update on protein-energy wasting in chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2015 May;18(3):254-62. doi: 10.1097/MCO.0000000000000171. Review. PubMed PMID: 25807354; PubMed Central PMCID: PMC4506466.
  • 2.Kalantar-Zadeh K, Tortorici AR, Chen JL, Kamgar M, Lau WL, Moradi H, Rhee CM, Streja E, Kovesdy CP. Dietary restrictions in dialysis patients: is there anything left to eat? Semin Dial. 2015 Mar-Apr;28(2):159-68. doi: 10.1111/sdi.12348. Epub 2015 Feb 3. Review. PubMed PMID: 25649719; PubMed Central PMCID: PMC4385746.
  • 3Therrien M, Byham-Gray L, Beto J. A Review of Dietary Intake Studies in Maintenance Dialysis Patients. J Ren Nutr. 2015 Jul;25(4):329-38. doi: 0.1053/j.jrn.2014.11.001. Epub 2015 Jan 13. Review. PubMed PMID: 25592493.
  • 4.Rocco MV. Does more frequent hemodialysis provide dietary freedom? J Ren Nutr. 2013 May;23(3):259-62. doi: 10.1053/j.jrn.2013.01.026. Review. PubMed PMID: 23611557.
  • 5.Mathewson AM, Fouque D, Toft AJ. Dietary phosphate assessment in dialysis patients. J Ren Nutr. 2010 Nov;20(6):351-8. doi: 10.1053/j.jrn.2010.05.014. Epub 2010 Sep 20. Review. PubMed PMID: 20850345.
  • 6.Dukkipati R, Noori N, Feroze U, Kopple JD. Dietary protein intake in patients with advanced chronic kidney disease and on dialysis. Semin Dial. 2010 Jul-Aug;23(4):365-72. doi: 10.1111/j.1525-139X.2010.00753.x. Review. PubMed PMID: 20701715.