Low-Protein Diet Strongly Reduces Need for Dialysis in CKD Patients: Study
A recent study published in the recent issue of Clinical Kidney Journal revealed that patients with advanced chronic kidney disease (CKD) who adopt a moderate low-protein diet (LPD) may significantly delay the progression to kidney failure and reduce the risk of death.
The retrospective study from January 2021 to December 2023, examined outcomes among 182 patients with advanced CKD. All patients were offered the option of following a moderate LPD (0.6 to 0.7 grams of protein per kilogram of body weight per day). Of these, 110 patients (over 60%) elected to adopt the diet, while 72 chose not to. Both groups received identical medical follow-up and care aside from dietary differences, allowing investigators to compare outcomes over time.
At baseline, there were no significant differences between the 2 groups in age, sex distribution, level of kidney function, or underlying medical conditions, strengthening the comparison of dietary impact. Over the study period, this study observed a notably slower decline in estimated glomerular filtration rate (eGFR) in the group adhering to the LPD. Those not following the diet showed a much more rapid annual loss in kidney function, with an average decline of −2.65 mL/min/1.73 m² per year, when compared to only −0.89 mL/min/1.73 m² per year among patients maintaining the dietary regimen.
The patients who chose the low-protein diet demonstrated an 84% lower risk of requiring kidney replacement therapy (dialysis), reflected in a hazard ratio of 0.16. All-cause mortality was also reduced by 78%, and the composite outcome of death or progression to dialysis by 81%. These figures emphasize not only the potential medical benefit but also the feasibility and patient acceptance of nutritional intervention.
The patients maintaining an LPD showed lower rates of progression to dialysis and mortality over the follow-up period, whereas patients who declined the diet experienced a more rapid kidney decline and a substantially higher rate of adverse outcomes. The effect sizes remained strong even when controlling for major comorbidities.
Overall, these findings suggest that offering an LPD as part of routine CKD care may provide a meaningful opportunity to extend kidney function and improve survival for patients willing to make dietary changes.
Source:
Vischini, G., Caissutti, S., Vetrano, D., Donini, S., Mastromauro, P., Chiocchini, A. L., Vella, A., Magnoni, G., Capelli, I., Piccoli, G. B., & La Manna, G. (2025). Low-protein diet with personalized support in advanced Chronic Kidney Disease: association with disease progression, dialysis delay, and mortality. Clinical Kidney Journal, sfaf341. https://doi.org/10.1093/ckj/sfaf341
