How does diet (salt, protein, and fluids) affect the progress of kidney disease?
Sodium restriction to less than 2 g/day in patients with CKD can facilitate better BP and volume control, as well as reducing albuminuria.
Early studies of dietary protein restriction suggested that a lower-protein diet decreased hyperfiltration and glomerular pressure and may potentially benefit the progression of kidney disease.
However, the large MDRD study failed to demonstrate a benefit in slowing kidney disease progression among people who reduced their protein intake, only delaying the onset of symptoms.
KDIGO currently recommends that patients at risk of progressive CKD to avoid high protein intake (>1.3 g/kg per day) and patients with CKD stage 4 should restrict protein intake to 0.8 g/kg per day.
