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JAMA Network Open

Low protein linked to kidney failure in a Korean kidney disease cohort

In South Korean chronic kidney disease patients not on dialysis, intake below 0.6 versus above 1.2 grams per kilogram daily was linked to kidney failure (hazard ratio 1.42).

Paper by Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, 17 more authorsSooyoung Cho · Chonnam National University
Kidney cross-sections show damaged tissue beside a small portion of tofu and more intact tissue beside a larger portion.
Cohort study of 1,861 people with nondialysis chronic kidney disease, median 9.3 yearsPopulations

Limit: Protein intake was estimated only at enrollment

Edited by Boris Djordjevic · AgingResearch.News

Paper
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An observational study followed 1,861 people in South Korea with chronic kidney disease who were not receiving dialysis. Their average age was 53.7 years. Researchers estimated daily protein intake from nitrogen in urine collected over 24 hours at enrollment. Median follow-up was 9.3 years.

Compared with the highest-intake group, the lowest-intake group had higher risks of kidney failure requiring dialysis or transplantation and death from any cause. The hazard ratio for death was 2.17; hazard ratios describe relative rather than absolute risk. The lowest intake was not associated with major cardiovascular events. The researchers suggested balancing strict protein restriction with nutritional monitoring and said more individualized dietary advice may be warranted.

Why it matters

Dietary management of chronic kidney disease raises a question relevant to aging: how to balance protein restriction with adequate nutrition, particularly in people with lower muscle reserves.

Caveats

This observational study cannot establish that low protein intake caused kidney failure or death, and researchers estimated intake only at enrollment. The findings concern people with chronic kidney disease in South Korea who were not receiving dialysis.

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