Protein Intake and Kidney Outcomes in Nondialysis Chronic Kidney Disease Over 15 Years

Is lower dietary protein intake (DPI), measured by 24-hour urine collections, associated with favorable outcomes in adults with stages 3 and 4 chronic kidney disease (CKD)?In this cohort study of 1441 adults, normalized DPI (nDPI; grams per kilogram body weight per day) was estimated from 24-hour urinary nitrogen excretion. In matched analyses, nDPI less than 1.0 was associated with lower risk of the composite outcome (≥50% estimated glomerular filtration rate decline, dialysis initiation, or death) and dialysis initiation, without meaningful differences in nutritional markers.These findings suggest that moderate protein intake (nDPI <1.0 g/kg per day) with objective monitoring may be associated with favorable kidney outcomes in routine CKD care.

Corresponding Author: Ilia Beberashvili, MD, Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, Israel (iliab@shamir.gov.il).

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