I am 47 with CKD stage 3. Should I cut back on protein?

Question

Hello doctor,

I am 47 years old with diabetes and was recently diagnosed with stage 3 chronic kidney disease. My most recent estimated glomerular filtration rate (eGFR) is 48, and my creatinine level is 1.6. My urine albumin-to-creatinine ratio came back at 380 mg/g. I am currently taking Losartan 50 mg and Metformin.

My doctor advised me to monitor my protein intake, but I am confused about what that means.

Should I avoid all protein-rich foods or just limit animal-based sources?
How can I tell if my kidney function is worsening despite being on medications?
Also, is chronic kidney disease at this stage reversible, or is it always progressive even with good management?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Based on your lab results and diagnosis, you are currently in stage 3a chronic kidney disease (CKD), with an estimated glomerular filtration rate (eGFR) of 48 and a urine albumin-to-creatinine ratio of 380 mg/g, indicating moderate albuminuria. This stage is still manageable, especially if your diabetes and blood pressure are well controlled. While CKD is not usually reversible, it can often be stabilized or its progression significantly slowed.

Your doctor’s advice to monitor your protein intake does not mean eliminating protein entirely, but rather moderating it, especially from animal sources, which can put more strain on the kidneys. Aim for about 0.27 to 0.36 grams of protein per pound of body weight per day. For example, if you weigh around 154 pounds (70 kilograms), your daily protein intake should be approximately 42 to 56 grams. Emphasize plant-based protein sources like lentils, tofu, and beans, and avoid processed meats and foods high in phosphorus.

Monitoring kidney function includes tracking your eGFR and creatinine every three to six months, watching for worsening lab values, and paying attention to symptoms like swelling, fatigue, or changes in urination.

You are already on a kidney-protective medication (Losartan), and SGLT2 inhibitors, like Empagliflozin, can further help protect kidney function in people with diabetes. If not yet prescribed, you should use it.

Maintaining good blood sugar and blood pressure control, following a low-sodium diet, and avoiding nephrotoxic medications like NSAIDs (non-steroidal anti-inflammatory medicines) are also crucial for kidney health.

You are already taking the right steps, and with continued attention to these factors, it is very possible to maintain stable kidney function for many years at this stage.

I hope I have answered your question. Let me know if I can assist you further.