I’ve heard different conflicting information about how much protein I need with chronic kidney disease. How much is the right amount for me? Does it matter what kind of protein I eat?
As a general guideline, moderate-protein diets are typically recommended for patients pre-dialysis and high-protein diets are typically recommended for dialysis patients since protein is lost during dialysis treatments. The amount of protein in your meals must be enough to replace what you lose during dialysis and to meet your daily needs. Very low-protein diets are usually no longer the recommendation.
If your diet is lacking protein, your body may begin to break down your muscles as a source of protein. This can lead to a lack of energy, muscle loss and weakness, an increase in the number of infections, slower healing and even swelling, especially of the feet and ankles. Protein is also important for tissue growth and repair and preventing anemia.
You will know if you are getting enough protein by watching your albumin levels in your blood work. Albumin is a type of protein in the blood. When the albumin level is low, typically less than 3.8 mg/dL, it can begin to affect your health. Low levels of albumin are linked to increased rates of hospitalization and early death in chronic kidney disease and dialysis patients. It is essential to eat enough protein so that serum albumin is maintained at the desired level.
The type of protein and/or combination of protein in your diet does matter. There are two kinds of protein: complete and incomplete. You need both kinds of proteins. Complete sources of protein are found in milk, eggs, meat, poultry, fish and seafood, and contain all nine essential amino acids, which are the building blocks of protein. Plant proteins come from vegetables, breads and cereals and lack some of the essential amino acids. That is why their protein is often called “incomplete.” It is recommended that at least 50 percent of your protein needs come from complete protein sources and could even be as high as 75 percent. If you are a vegetarian, with proper planning, it is possible to get all of your essential amino acids through specific food combinations.
Recent literature does not support strict protein restrictions in this patient population. A recommended intake is 0.8 grams/kilogram of ideal body weight per day.
Protein: Most people on dialysis are encouraged to eat as much high-quality protein as they can. The better nourished you are, the healthier you will be. You will be encouraged to eat 1.0-1.5 grams of protein per kilogram of ideal body weight per day, at a minimum.
Peritoneal Dialysis Patients
Each time you do a PD exchange, you remove up to 9 grams of protein (approx. 1 oz. of meat). Patients on peritoneal dialysis are advised to follow a high-protein diet because protein is lost through the dialysis. You will be encouraged to eat 1.2-1.4 grams of protein per kilogram of ideal body weight per day, at a minimum.
To calculate how much protein you should consume per day, follow the equation below. Always follow your physician and/or dietitian’s recommendations. These are simply guidelines.
You will first need to figure out your Ideal Body Weight (IBW).
To do this:
Women – First 5 ft = 100 lbs; every inch above 5 feet, add 5 pounds
Men – First 5 ft = 106 lbs; every inch above 5 feet, add 6 pounds
To calculate the amount of protein to eat per day:
1. Ideal Body Weight (insert your number) / 2.2 (kg) = Weight (kg)
2. Weight (kg) x amount of protein stated above (ex. .8, 1.2, or 1.5) = g of protein to eat per day
Example: 5-foot-3 Woman
1. IBW =100 lbs + (3 x 5 lbs) = 115 lbs
2. 115 lbs/ 2.2 = 52.3 kg.
3. 52.3 (kg) x .8 (pre-dialysis requirements) = 42 g of protein/day
4. Equates to 6 oz (1 oz = 7 g of protein)