High protein diets & kidney disease

Executive summary

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In December 2019, ‘Anon’ asked if I could review an article that he’d seen in Medscape entitled “High-Protein Diet Could Be Harmful, Even for Healthy Kidneys” (Ref 1). I put it on the possible Monday note list. Then Hans van Kuijk, MD, a sports and exercise physician, emailed me towards the end of February 2020 to ask if I could look at another Medscape article. This one was called “High-Protein Diet Is Bad for Kidney Health” (Ref 2). As interest in the topic had doubled (😉) I decided to take a look. (Notice immediately how “could be harmful” has become “is bad for”…)

Both Medscape articles turned out to be about the same two studies. One was from the Netherlands and the other from Korea. The Dutch article was called “Dietary protein intake and kidney function decline after myocardial infarction: the Alpha Omega Cohort” (Ref 3). The Korean article was called “High-protein diet with renal hyperfiltration is associated with rapid decline rate of renal function: community-based prospective cohort study” (Ref 4).

Measurement of kidney function

Both studies used the same standard measurement of kidney function – estimated glomerular filtration rate – which is abbreviated to eGFR. This is a measurement of the filtration rates of the functioning nephrons in the kidney. (A nephron is a filtering unit). The average nephron number is approximately 900,000 to 1 million per kidney (Ref 5).


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