Dietary Protein Intake Recommendations for Patients with Non–Dialysis-Dependent CKD

May 30, 2025Clinical journal of the American Society of Nephrology : CJASN

Protein Intake Guidelines for Patients with Kidney Disease Not on Dialysis: Advice for Healthcare Providers

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Abstract

An adequate dietary protein intake (DPI) of approximately 0.6-0.8 g/kg body weight/d is crucial for patients with chronic kidney disease (CKD) stages 3-5.

Insufficient DPI (<0.6 g/kg body weight/d) and excessive DPI (>1.3 g/kg body weight/d) may pose health risks in patients with CKD.
Healthcare providers should understand the effects of both inadequate and excessive DPI to optimize patient outcomes.
The Kidney Disease Outcome Quality Initiative guidelines provide evidence-based recommendations for dietary interventions regarding DPI.
Recent Kidney Disease Improving Global Outcomes guidelines recommend a DPI of 0.8 g/kg body weight/d while advising against exceeding 1.3 g/kg body weight/d.
Individualized dietary approaches are necessary, taking into account patient characteristics and systemic factors for successful implementation.

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Protein intake is crucial to maintain human health, and an adequate quantity and quality of dietary protein intake (DPI) is particularly important in patients with CKD. Both an insufficient amount of DPI ( i.e ., <0.6 g/kg body weight (body wt)/d) and an excess amount of DPI ( i.e ., >1.3 g/kg body wt/d) pose potential health hazards in patients with CKD stages 3-5. Therefore, to optimize patient outcomes, healthcare providers should be familiar with the effects of both inadequate and excessive DPI in this population. The Kidney Disease Outcome Quality Initiative guidelines on DPI are rooted in detailed analyses of available scientific evidence and provide detailed recommendations regarding different dietary interventions strategies to achieve optimal quantity and quality of DPI. The more recent Kidney Disease Improving Global Outcomes guidelines on CKD management have a substantially broader scope and include a relatively brief section on diet, recommending a DPI of 0.8 g/kg body wt/d, emphasizing the need to avoid a DPI of >1.3 g/kg body wt/d. Besides aiming for a DPI of approximately 0.6-0.8 g/kg body wt/d in patients with CKD stages 3-5, successful practical implementation of dietary interventions requires an individualized approach which considers patient characteristics, such as sociocultural norms, habitual dietary habits, and nutrition literacy as well as systemic factors such as feasibility and availability of interventions.

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Dietary Protein Intake Recommendations for Patients with Non–Dialysis-Dependent CKD

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