In Which Stage of Kidney Disease Should You Consume Protein?


If you have kidney disease, nutrition is likely one of the most important components of your treatment. Knowing what foods to eat, as well as what foods to avoid, can be key in staying strong, healthy, and at lower risk of infections. 
 
Kidneys are responsible for eliminating the waste and extra fluid in the body. However, when you have kidney disease, your kidney function starts to decrease. If kidney disease gets worse, waste can buildup in high levels in your blood causing high blood pressure, anemia, weak bones, and nerve damage. Having kidney disease may also increase your risk of developing heart disease.  


Kidney disease slowly progresses into what is characterized as stages. There are five stages of kidney disease which are measured by the Glomerular Filtration Rate (GFR). The GFR is a formula that uses a person’s age, race, and serum creatine to determine the progression of the disease. Creatine is waste that results from muscle activity. When kidneys are performing, they are removing creatine’ when they are not, blood levels of creatine rise. Below are the five stages and their respective GFR:  
 
1) Stage 1 Normal (GFR > 90): At this stage there is very mild damage to the kidneys and treatment can be very adaptable. There is usually no symptoms and treatment can include physical activity and maintaining a balanced diet.  

2) Stage 2 Mild CKD (GFR 60-89): At this stage, individuals can start experiencing high blood pressure and there may be presence of protein or blood in the urine. A healthy kidney diet, including fresh foods, low sodium, and healthy proteins, is the best treatment.  

3) Stage 3 Moderate CKD (GFR 30-59): At this stage the symptoms start to become more noticeable, as they include fatigue, fluid retention, dark colored urine, pain in the lower back and sleep problems. Here a healthy diet, limiting sodium and cholesterol, and increasing fresh foods and physical activity, is the course of treatment.  

4) Stage 4 Severe CKD (GFR 15-29): This is the last stage before kidney failure and is when patients start talking with their doctors about dialysis. Symptoms are similar to those from Stage 3 but include bone disease and increased urination. Diet must include foods high in potassium and protein consumption must be kept to a minimum.  

5) Stage 5 Kidney Failure (GFR < 15):At this point there is renal failure as both kidneys are no longer working sufficiently to keep the body healthy. Symptoms include nausea, vomiting, abnormal thyroid levels, swelling in the extremities, fatigue, and shortness of breath. At this point treatment includes dialysis or a kidney transplant. 

Dialysis

Dialysis is the treatment for kidney failure that helps your body eliminate toxins, waste, and excess fluids by filtering the blood. Dialysis acts as an “artificial kidney” that helps keep the fluids and electrolytes in balance and reduce the risk of protein buildup.

There are three different types of dialysis: hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT). Hemodialysis is the most common type of dialysis, where an artificial kidney is used to remove waste and fluid from the blood. Peritoneal dialysis involves surgery to implant a catheter into the abdomen, which will help you filter blood. During treatment, a fluid called dialysate absorbs waste out of the bloodstream. CRRT is primarily used for individuals with acute kidney failure. This process involves a machine passing blood through tubing, by which a filter removes waste and water.

Kidney Disease and Protein

Protein is a micronutrient that allows our bodies to function, grow, and heal properly. Protein provides us with the amino acids required for us to maintain bone mass, fight infections, grow muscle, and repair our tissues. Although everyone needs protein, individuals with kidney disease have to watch their protein intake as too much protein is harmful for their kidneys.

Patients with kidney disease between stages 1 through 4 should limit their protein intake. When kidneys are not functioning properly, the body may not be able to remove all the waste from the protein in the diet, causing the byproducts of protein to build up and damage the other organs. This is why individuals with kidney disease are advised to limit their protein intake, as the more waste your body needs to remove, the harder your kidneys need to work. The goal is to reduce protein consumption to help slow down the loss of kidney function.

Dialysis and Protein

At the stage 5, when individuals start dialysis, the protein requirements change. Individuals now need a higher amount of protein to make up for the protein lost during treatment. By having an “artificial kidney” individuals can increase their protein intake without the risk of buildup.

Albumin is the most common protein found in blood. Albumin is responsible for delivering the vitamins and minerals from food to the rest of the body. Albumin also helps keep the fluids you drink in your cells and blood vessels. When dialysis removes the buildup of waste from your blood, it also removes some of the albumin. Albumin can help patients fight infections and undergo less hospitalizations. Dialysis patients have their albumin checked on a monthly basis to ensure that their levels are adequate and at par with their protein requirements. If they are lacking in protein, the body will start to break down the muscles to get the protein it needs.

Takeaway

Kidney disease involves five stages that are categorized by the progression of the disease. While patients suffering from kidney disease are advised to limit their protein intake, once they start dialysis these requirements change, and they are encouraged to increase their protein consumption. During dialysis, patients need to ensure that they’re getting the right amount of protein to help the body build and repair muscle, heal wounds, and fight infections.

Our liquid protein supplement, Proteinex, has been assisting dialysis patients with their protein needs for over 15 years! Why? It’s a high-quality lean protein source that contains a high dose of protein in a small serving size, making it a convenient alternative for dialysis patients. It’s low in phosphorus, can be taken directly or mixed, and comes in a variety of flavors.

Ask your doctor about incorporating Proteinex to your dialysis diet or contact our team for more information.

References 

https://www.kidney.org/atoz/content/about-chronic-kidney-disease

https://www.kidney.org/atoz/content/nutrikidfail_stage1-4

https://www.kidneyfund.org/kidney-today/a-dietitians-guide-to-protein-for-dialysis-patients.html

http://nephron.org/nephsites/adp/protein.htm

https://www.freseniuskidneycare.com/ckd-treatment/what-is-dialysis