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Dietary Protein, Kidney Function and Mortality: Review of the Evidence from Epidemiological Studies

Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”, Università di Salerno, 84081 Baronissi (SA), Italy
Dipartimento di Fisica, Università di Salerno, 84084 Fisciano (SA), Italy
Dipartimento di Sanità Pubblica, Università Federico II, 80131 Naples (NA), Italy
Author to whom correspondence should be addressed.
Nutrients 2019, 11(1), 196;
Received: 3 January 2019 / Revised: 15 January 2019 / Accepted: 16 January 2019 / Published: 18 January 2019
The World Health Organization recommends a minimum requirement of 0.8 g/day protein/kg ideal weight. Low protein diets are used against kidney failure progression. Efficacy and safety of these diets are uncertain. This paper reviews epidemiological studies about associations of protein intake with kidney function decline and mortality. Three studies investigated these associations; two reported data on mortality. Protein intake averaged >60 g/day and 1.2 g/day/kg ideal weight. An association of baseline protein intake with long-term kidney function decline was absent in the general population and/or persons with normal kidney function but was significantly positive in persons with below-normal kidney function. Independent of kidney function and other confounders, a J-curve relationship was found between baseline protein intake and mortality due to ≈35% mortality excess for non-cardiovascular disease in the lowest quintile of protein intake, a quintile where protein intake averaged <0.8 g/day/kg ideal weight. Altogether, epidemiological evidence suggests that, in patients with reduced kidney function, protein intakes of ≈0.8 g/d/kg ideal weight could limit kidney function decline without adding non-renal risks. Long-term lower protein intake could increase mortality. In most patients, an intake of ≈0.8 g/day/kg would represent a substantial reduction of habitual intake considering that average intake is largely higher. View Full-Text
Keywords: dietary protein; kidney function; mortality; epidemiology dietary protein; kidney function; mortality; epidemiology
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Bilancio, G.; Cavallo, P.; Ciacci, C.; Cirillo, M. Dietary Protein, Kidney Function and Mortality: Review of the Evidence from Epidemiological Studies. Nutrients 2019, 11, 196.

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