What is the effect of dietary protein restriction on glomerular filtration rate (GFR) in chronic kidney disease (CKD)?

Updated: Oct 26, 2020
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In the Modification of Diet in Renal Disease (MDRD) Study, dietary protein restriction (0.58 g/kg/day, versus a usual-protein diet of 1.3 g/kg/day) did not significantly affect the mean change in glomerular filtration rate (GFR) over 3 years. Secondary analyses, however, suggested that a low-protein diet may slow the GFR decline in patients with the most rapidly declining GFR and reduce proteinuria. [64] A meta-analysis by Kasiske et al suggested that dietary protein restriction retards the rate of renal function decline, but the magnitude of the effect is relatively weak. [65]

National Kidney Foundation (NKF) guidelines advise that if a patient is started on protein restriction, the physician needs to closely monitor the patient's nutritional status. [45] Predialysis low serum albumin is associated with a poor outcome among dialysis patients. Protein restriction is not recommended in pediatric patients with CKD.


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