Protein and Kidney Disease: Low-Protein Diets, Dialysis and Why Powders Need Clinician Approval

Start here: kidney disease and protein is a clinician decision

If you have chronic kidney disease (CKD), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says some people with CKD may need only moderate amounts of protein so waste does not build up in the blood, while too little protein can lead to malnutrition. [1] It advises working with a dietitian or health care professional to find the right balance. [1] KDIGO, an international kidney guideline group, also advises that a renal dietitian or accredited nutrition provider teach people with CKD about protein, sodium, phosphorus and potassium. [2]

This page is information only. Do not start a protein powder or amino acid product, or cut your protein, without your kidney team. On dialysis, NIDDK warns against over-the-counter nutritional supplements and says to talk with your health care provider before using dietary supplements. [3]

How to read the evidence on this page

We label findings: "guideline recommendation" (an expert group's advice, with its own rating of the evidence), "mixed" (studies disagree), "evidence in adequately nourished people" (trials in people without the condition), and "Proper evidence not found" (we searched and found nothing usable). A change in a lab value is not the same as a change in health outcomes.

What guidelines say about protein in CKD

Amounts below are grams of protein per kilogram of body weight per day (g/kg/day), not grams of food. KDIGO notes that 100 g of meat contains only approximately 25 g of protein. [2]

The commentary we read does not state the CKD stages or dialysis status for the KDOQI ranges. The guidelines do not match, and a 2025 review calls the benefit of low-protein diets for altered kidney function "controversial". [5] KDIGO adds that low-protein diets should not be prescribed to metabolically unstable people with CKD. [2] NIDDK says protein needs may change over time. [1] A "very low protein plus supplements" plan is a prescribed medical treatment, not a sports-nutrition product; the sources we read do not describe store-bought amino acid products as a substitute for it.

Dialysis

Dialysis changes the picture. NIDDK says people with CKD on dialysis may need to eat more protein because treatment removes protein from the blood, and that peritoneal dialysis removes more than hemodialysis. [1] For hemodialysis, NIDDK says renal dietitians encourage most people to eat high-quality protein because it produces less waste to remove. [3] Because phosphorus is also found in protein-rich foods, the amount and type of protein is set with a renal dietitian. [3]

Children and growth

KDIGO says not to restrict protein in children with CKD because of the risk of growth impairment. [2] Guidance for pregnancy, breastfeeding and older adults with CKD was not found in the sources we read for this page, so ask the kidney team.

Healthy kidneys: what trials show

A 2018 meta-analysis of 28 trials in healthy adults without kidney disease (1358 participants) compared higher-protein diets (at least 1.5 g/kg, or 20 percent of energy, or 100 g a day) with lower or normal intakes. [6] It concluded that higher-protein intakes did not adversely influence kidney function, measured by glomerular filtration rate (GFR), in healthy adults. [6] Its main limitation was unclear risk of selection bias in the trials. [6] These findings are for adults without kidney disease and cannot be carried over to people with CKD. KDIGO's view is that people with CKD have the same protein requirements as healthy people, and that high intakes may be harmful for the kidney. [2]

Diabetes and kidney disease

The American Diabetes Association (ADA) 2025 Standards of Care say reducing protein below the recommended allowance of 0.8 g/kg is not recommended for diabetes-related CKD, because it does not change glycemic measures or the rate of eGFR decline and may raise the risk of malnutrition. [7] Note that this differs from the KDOQI numbers above, which is why a kidney dietitian decides. See Protein, Blood Sugar and Diabetes.

Related

Protein Foundations · Protein Liver Disease · Protein and Amino Acid Safety Quick Reference