Mr. Minh had chronic kidney disease seven years ago. He took various medications, but when he experienced prolonged fatigue and foamy urine, he sought medical attention at Tam Anh General Hospital in TP HCM. Test results revealed a glomerular filtration rate of 30 ml/min/1,73 m², indicating stage three kidney failure, anemia, mixed hyperlipidemia, hypertension, and several comorbidities, including atherosclerosis, gout, bilateral renal cysts, and prostate enlargement.

He underwent comprehensive treatment at the Nephrology - Dialysis Department, part of the Urology - Nephrology - Andrology Center. The treatment aimed to slow the progression of kidney failure, control blood pressure, manage anemia, address lipid disorders, and control gout. His kidney function gradually stabilized and improved significantly, with his glomerular filtration rate recovering to approximately 50 ml/min/1,73 m².

However, in an attempt to accelerate kidney function improvement, Mr. Minh began combining his prescribed medication with online remedies and diets. He arbitrarily and excessively reduced his protein intake, cutting out meat, fish, and eggs from his daily meals. Less than three months later, doctors discovered his glomerular filtration rate was fluctuating erratically, putting him at risk of progressing to stage four kidney failure.

Mr. Minh regularly attends follow-up appointments at Tam Anh General Hospital in TP HCM. *Photo: Duy Duong*

After ruling out all other potential causes for the decline in kidney function, Dr. Ta Phuong Dung, Deputy Director of the Urology - Nephrology - Andrology Center and Head of the Nephrology - Dialysis Department, identified Mr. Minh's self-imposed protein restriction over the past few months as the reason for his worsening kidney failure.

"An improperly managed low-protein diet can be more harmful than beneficial for the kidneys, because not all chronic kidney disease patients need to eat less protein", Dr. Dung explained.

In healthy individuals, protein plays a vital role in muscle development, immune function, and tissue regeneration. Prolonged protein restriction can easily lead to malnutrition, muscle atrophy, hypoalbuminemia, resulting in edema and an increased risk of infection. Chronic kidney disease patients who consume too little protein and lack energy also force their bodies to break down muscle, increasing the metabolic burden on their kidneys.

According to Dr. Dung, restrictive diets, completely avoiding meat and fish, or adopting unverified methods can lead to the silent progression of the disease to severe stages. Dietary plans need to be individualized, tailored to the specific patient, their condition, and their physical state, prioritizing high-quality protein sources and balanced energy intake.

According to the U.S. National Institutes of Health, the recommended daily allowance (RDA) for healthy adults is approximately 0,8 g of protein per kg of body weight per day. For patients with stage three kidney failure, like Mr. Minh, the protein intake should be around 0,6-0,8 g/kg/day (if not diabetic) or 0,8-0,9 g/kg/day (if diabetic). Priority should be given to protein from lean pork, chicken, fish, and eggs, combined with plant-based protein, while limiting red meat, seafood, and processed foods due to their high sodium and phosphorus content.

Dr. Dung adjusted Mr. Minh's diet, guided him on proper medication use, and incorporated specialized nutritional milk for kidney patients. After over three years of treatment and regular monitoring, his kidney function improved from stage four kidney failure back to stage three, with his glomerular filtration rate approaching 50 ml/min/1,73 m² at his latest follow-up.

"I take my medication regularly, keep my follow-up appointments, and hope to avoid dialysis", Mr. Minh said.

Ha Thanh

*Patient's name has been changed