Table 1.
Ranges of dietary protein intake vis-à-vis relevant kidney disease conditions in the context of the KDOQI CPG in Kidney Disease 2020
| Dietary Protein Intake Range | Daily Grams of Protein Intake per kg Body Weight (g/kg/day)* |
Comment |
|---|---|---|
| Protein-free diet | <0.25 g/kg/day | Generally not recommended for any person including CKD patients. |
| Very low-protein diet | 0.25-0.55 g/kg/day | Usually supplemented with essential amino acids or their ketoacids or hydroxy-acids. KDOQI CPG recommends 0.28 to 0.43 g/kg/day with additional keto acid/amino acid analogs to meet protein requirements (0.55 to 0.60 g/kg body weight/day) for metabolically stable CKD patients without diabetes. |
| Low-protein diet for nondiabetic CKD† | 0.55-0.6 | Recommended by KDOQI CPG for CKD patients without diabetes. |
| Low-protein diet (for DKD† | 0.6-0.8 g/kg/day | More consistently recommended for advanced CKD (eGFR<45 ml/min/1.73m2 or substantial proteinuria), usually no supplementation is needed as long as the regimen contains at least 50% high biologic value proteins. This range is recommended by KDOQI CPG for CKD patients with diabetes. |
| Moderately low-protein intake | 0.8-1.0 g/kg/day | Recommended range for adults without CKD but at high risk of CKD including those with a solitary kidney (following nephrectomy), diabetes mellitus, hypertension, and polycystic kidneys. |
| Moderate protein intake | 1.0-1.2 g/kg/day | Recommended by KDOQI CPG for metabolically stable patients on maintenance HD or PD. |
| Moderately high-protein diet | 1.2-1.5 g/kg/day | Reported protein intake of average United States adult without CKD. |
| High- to very high-protein diet | >1.5 g/kg/day | Can be used over limited period of time for acute conditions such as hypercatabolic AKI, high-grade burns, and PEW. |
AKI, acute kidney injury; CKD, chronic kidney disease; CPG, clinical practice guideline; DKD, diabetic kidney disease; DPI, dietary protein intake; eGFR, estimated glomerularfiltration rate; HD, hemodialysis; KDOQI, Kidney Disease Outcomes Quality Initiative; PD, peritoneal dialysis; PEW, protein-energy wasting.
Adapted from Supplementary-Appendix Table S3 by Kalantar-Zadeh and Fouque.1
KDOQI CPG in Kidney Disease 2020 states it may be reasonable for a Registered Dietitian or Physician to use clinical judgment in determining the method to assess body weight.
Recommended by the KDOQI Clinical Practice Guidelines in Kidney Disease.