Many kidney disease patients reduce or completely eliminate meat, fish, and eggs, fearing that high protein intake overworks their kidneys. However, excessive protein restriction can lead to protein deficiency, malnutrition, and muscle loss.

Protein is essential for muscle maintenance, hormone and enzyme production, and immune system function. Yet, protein metabolism generates substances that the kidneys must process. When kidney function declines, protein intake requires careful adjustment to reduce kidney burden while ensuring the body's nutritional needs.

Kidney patients should not self-implement a "the less protein, the better" diet. The appropriate protein amount depends on the disease stage, weight, physical condition, nutritional status, co-existing medical conditions, and whether the patient is undergoing dialysis.

For a patient with stage 4 chronic kidney disease who is not yet on dialysis, completely removing meat, fish, and eggs from the diet is not advisable, as it can increase the risk of protein deficiency and muscle loss. Prioritize protein sources from: fish, eggs, lean meat, and poultry (skin removed). Limit processed meats like: sausages, cold cuts, cured pork, and bacon, as they contain high levels of salt, preservatives, and additives that are not beneficial for kidney patients. Dishes should be prepared by boiling, steaming, braising, or cooking with low salt, and deep-frying should be limited.

Dr.CKII Ho Tan Thong advises patients on diet at the Nephrology - Dialysis Unit. Illustration: Tam Anh General Hospital.

If not yet on dialysis, the recommended protein intake is typically around 0,6-0,8 g/kg body weight/day, depending on individual cases and doctor's orders. For example, a person weighing 60 kg might need about 36-48 g of protein daily. If already on dialysis, excessive protein restriction can be detrimental; patients usually require about 1-1,2 g/kg body weight/day, depending on their physical condition and co-existing medical conditions.

Additionally, depending on kidney function and lab test results, some patients may also need to control salt, potassium, phosphorus, or fluid intake.

Patients with kidney disease not on dialysis need to consume sufficient energy, balance protein, vegetables, and starches, while also controlling potassium and phosphorus. Prioritize refined starches such as: white rice, vermicelli, rice noodles, and pho; protein from: lean meat, skinless chicken breast, and egg whites; and low-potassium vegetables like: bottle gourd, winter melon, chayote, cucumber, and loofah. Limit whole grains, organ meats, red meat, and dark green vegetables. Food should be cooked blandly, without adding extra salt or fish sauce, to control edema and blood pressure.

Patients should have regular follow-up appointments to monitor kidney function, electrolytes, and nutritional status, allowing doctors to adjust protein intake and diet as needed.

Dr.CKII Ho Tan Thong

Nephrology - Dialysis Unit

Tam Anh General Clinic District 7