Nutritional Therapy for Chronic Kidney Disease

For the past decades, it has been considered that CKD patients with obvious proteinuria should have high-protein diets to provide enough nutrition and at the same time making up for the lost proteins in urine.

However, the amount of protein intake will affect the severity of proteinuria. Glomerular protein transfer will induce high catabolism and oxidative stress causing inflammations and affecting protein synthesis.

Increasing protein intake can not benefit CKD patients but instead will increase its complications and mortality. On the contrary, limiting protein intake can bring a lot of benefits such as increase of serum albumin, delay illness progression and interstitial fibrosis, alleviate edema and reduce renal tubular exposure in complements, iron and growth factors.

Many researches have shown that low-protein diets can reduce proteinuria which is typical symptoms of chronic kidney disease and will cause further renal damages if left untreated.

Proper protein intake for chronic kidney disease patients should be 0.6g/kg/d. For those that are below 60, calorie intake should be 35kcal/kg/d and for those that are above 60, it should be 335kcal/kg/d. Protein and calorie intake should be reduced along with decline of renal functions. For example, CKD stage 3 (GFR<30mL/min)patients can only have 21kcal/kg per day.

The quality of protein and sources of protein also count a lot. Vegetable proteins will have more energy consumption and produce more waste products, therefore there should be at least 50% high quality proteins such as egg white, lean meat, milk and fish.

Keto acids medicines such as ketosteril can provide essential amino acids and at the same time will not increase nitrogen-related wastes and they can be used as one of the treatment of proteinuria in CKD.

Keto acids can help slow down illness progression of CKD and improve their nutritional states. Recent studies have also found that it can reduce protein loss in urine, help control high blood pressure and reduce risk factor of cardiovascular diseases. Keto acids along with low-protein diets can help achieve low-protein but high-calorie nutrition for CKD patients with massive proteinuria.