By Isabelle Guindon, RD
Are you or a loved one living with chronic kidney disease (CKD), recently started dialysis, or preparing to transition to dialysis treatment?
Some of the information out there on nutrition for CKD and for those on dialysis can be conflicting and may leave you wondering, “How does this apply to me?” In this post, we’ll be explaining how exactly protein needs can vary, from person to perso,n and how they differ for individuals with CKD who are not on dialysis compared to those who are.
I’m not on dialysis and have been told to restrict my protein intake – is this necessary?
It depends! Many different factors can influence our protein needs, which is why some people need more protein than others. Here are just a few things that can impact our needs:
- Stage of CKD: often waste products from protein metabolism are not eliminated as efficiently by the kidneys in those with more advanced stages of CKD, so in those with elevated levels of waste products from protein metabolism in their blood, a more limited protein diet may be needed.
- Other chronic diseases or surgeries: forthose living with another chronic disease, incorporating protein may be important for managing their condition (i.e. those with diabetes). Protein needs are also increased in those who have recently had a major surgery, to help promote healing.
- Age: Children and teens need more protein for growth, so for them protein is not usually restricted as much as adults.
The amount of protein that someone not on dialysis will need is often unique to the
individual. Working with a Registered Dietitian specialized in kidney disease can be very helpful to better understand your personal needs.
I’m going to be starting dialysis soon – will this impact my protein needs?
Yes! Usually, people on dialysis need more protein. There are a few reasons behind this, the main one being that during dialysis, protein is also removed alongside waste products and fluid from the body, so we need to replace what is being lost. For those on peritoneal dialysis, needs will be higher than those on hemodialysis, since there are more losses through this type of dialysis.
For those with chronic kidney disease not on dialysis, protein intake may be more limited. When protein is broken down in the body, it creates waste products, which are normally removed from the body by the kidneys. In those living with chronic kidney disease, the kidneys are not as efficient in removing these waste products, so this can make them work harder and cause damage to them, and these products can build up in the body, causing symptoms like nausea, fatigue and poor appetite. Once you start dialysis, protein does not need to be restricted as much since dialysis removes these waste products from the body.
Are certain types of protein better for those with chronic kidney disease, both on and not on dialysis?
There is some evidence that eating more plant-based proteins (think legumes, nuts, tofu and whole grains) may have benefits for those living with chronic kidney disease. Many of these foods also have other health benefits, including higher amounts of fibre, vitamins & minerals and antioxidants. This may help control blood pressure, lower cholesterol, and better control blood sugars.
These foods also tend to be less processed and less likely to have additives that may
contain things like potassium and phosphate that are very easily absorbed by the body and can build up in the blood in those with chronic kidney disease. Plant-based proteins can also have additional health benefits when compared to animal-based proteins for those with chronic kidney disease. Learn more about the benefits of plant-based proteins in this blog post.
Bottom line, while generally those with CKD not on dialysis are told to follow a lower protein diet, and for those on dialysis generally need to eat more protein, everyone’s protein needs are individual. Several factors can impact protein needs, like age, other health conditions, stage ofCKD and type of dialysis. To better understand your individual protein needs, a great option is to meet with a Registered Dietitian specializing in treating those with kidney disease. Learn more about the importance of working with a Registered Dietitian and how to find one in this blog post.