Diet in renal disease

The renal diet is:

• low in phosphate (6.5 mg/kg/day)
• low in potassium (0.6 g/kg/day)
• low in protein
• high in fibre
• low in water soluble vitamins and so careful supplementation is indicated

A meta-analysis of published randomised controlled trials has revealed that 'dietary protein restriction reduces the risk of renal failure or death in nondiabetic renal disease and improves nephropathy in insulin-dependent diabetes mellitus' (1).

A systematic review found that (2):

• reducing protein intake in patients with chronic kidney disease reduces the occurrence of renal death by 31% as compared with higher or unrestricted protein intake
• optimal level of protein intake cannot be confirmed from the studies examined

NICE however state (3):

• Do not offer low-protein diets (dietary protein intake less than 0.6-0.8 g/kg/day) to people with CKD

Reference:

1. Fouque D. Meta-analysis: dietary protein restriction delays progression in renal disease. EBM 1 (5), 147.
2. Fouque D et al. Low protein diets for chronic kidney disease in non diabetic adults. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD001892.
3. NICE (August 2021). Chronic kidney disease: assessment and management