Patients with Chronic Kidney Disease Face 117% Higher Risk of Death When They Restrict Protein Too Much

KDCA analyzes long-term follow-up of Korean patients
Risk of end-stage kidney disease 42% higher
"Adequate intake matters more than blanket restrictions"

A study has found that excessive protein restriction in patients with chronic kidney disease may actually increase their risk of end-stage kidney disease requiring dialysis or a kidney transplant, as well as their risk of death.

The Korea Disease Control and Prevention Agency's National Institute of Health announced on November 10 that a long-term follow-up of 1,861 Korean patients with chronic kidney disease who were not receiving dialysis found higher risks of end-stage kidney disease and death among patients with very low protein intake.

A research team led by Kim Suwan and Seo Sangheon, professors in the Division of Nephrology at Chonnam National University Hospital, analyzed the association between daily protein intake and the risks of kidney failure progression and death among patients with chronic kidney disease at nine university hospitals in Korea from 2011 to 2024.

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The analysis found that patients who consumed less than 0.6 g of protein per kilogram of body weight per day had a 42% higher risk of progressing to end-stage kidney disease requiring dialysis or a kidney transplant than those who consumed at least 1.2 g. Their risk of death from any cause was 117% higher. These associations remained even after adjusting for key factors, including age, sex, baseline kidney function, and diabetes status.

Patients with chronic kidney disease have been advised to limit protein intake to reduce the burden on their kidneys. However, excessive protein restriction can reduce the body's protein and energy reserves and lead to a condition known as protein-energy wasting, in which muscle mass declines.

Concerns have therefore continued to be raised that this could negatively affect patients' long-term health and survival. The 2024 KDIGO clinical practice guidelines also recommend that patients with chronic kidney disease who are not receiving dialysis consume about 0.8 g of protein per kilogram of body weight per day, the recommended intake for the general adult population.

Professor Seo said, "This study uses long-term follow-up data to show that indiscriminately reducing protein intake may not benefit every patient." He added, "This does not mean that high-protein diets are recommended. It is important to determine an appropriate intake for each patient in consultation with medical professionals and clinical dietitians, while assessing kidney function, nutritional status, and muscle mass."

This content was produced with the assistance of AI translation services.