included in the diet depends on the degree of kidney or
liver damage and the amount of protein needed for an
individual to maintain good health. Laboratory tests
are used to determine the amount of protein and pro-
tein waste breakdown products in the blood. A sug-
gested acceptable level of protein in a low-protein diet
is about 0.6g/kg of body weight per day, or about 40 to
50 grams per day. A person suffering from a kidney
disease such as nephrotic syndrome, where large
amounts of protein is lost in the urine, should ingest
moderate levels of protein (0.8 kg per kg of body
weight per day).
A sample menu for one day might include:
Breakfast: 1 orange, 1 egg or egg substitute, 1/2
cup rice or creamed cereal, 1 slice whole wheat bread
(toasted), 1/2 tablespoon margarine or butter, 1/2 cup
whole milk, hot, non-caloric beverage, 1 tablespoon
sugar (optional)
Lunch: 1 ounce sliced turkey breast, 1/2 cup
steamed broccoli, 1 slice whole wheat bread, 1/2 table-
spoon margarine or butter, 1 apple, 1/2 cup gelatin
dessert, 1 cup grape juice, hot, non-caloric beverage, 1
tablespoon sugar (optional)
Mid-Afternoon Snack: 6 squares salt-free soda
crackers, 1/2 tablespoon margarine or butter, 1 to 2
tablespoons jelly, 1/2 cup apple juice
Dinner: 1/2 cup tomato juice, 1 ounce beef, 1 baked
potato, 1 teaspoon margarine or butter (optional), 1/2
cup steamed spinach, 1 slice whole wheat bread, 1/3 cup
sherbet, 4 apricot halves, hot, non-caloric beverage
Evening Snack: 1 banana
This sample menu contains about 1850 calories,
with a protein content of 8%.
Special, low protein products, especially breads
and pastas, are available from various food manufac-
turers for persons who need to follow a low protein
diet. Specific information on the protein content of
foods can be found on food labels. Books that list
protein contents of various foods as well as low pro-
tein cookbooks are also available.
In addition, it is recommended that fat calories be
obtained from monounsaturated and polyunsaturated
fats. In order to be effective, some persons may also be
required to reduce theirsodiumand potassium inges-
tion in foods. Sodium restriction improves the ability
to control blood pressure and body fluid build-up as
well as to avoid congestive heart failure. Foods with
high sodium contents, such as processed, convenience
and fast foods, salty snacks, and salty seasonings,
should be avoided. Potassium is necessary for nerve
and muscle health. Dietary potassium restriction is
required if potassium is not excreted and builds to
high levels in the blood, which may result in dangerous
heart rhythms. At very high levels, potassium can even
cause the heart to stop beating.
As kidney function decreases, the kidneys may
reduce their production of urine, and the body can
become overloaded with fluids. This fluid accumula-
tion can result in swelling of legs, hands and face, high
blood pressure, and shortness of breath. To relieve
these symptoms, restriction of fluids, including
water, soup, juice, milk, popsicles, and gelatin, should
be incorporated into the low protein diet. Liver disease
may also require dietary fluid restrictions.
Tyrosinemia is a rare but serious inherited disease
that may also require the use of a low-protein diet.
Tyrosinemia is an inborn error of metabolism in
which the body can not effectively break down the
amino acid tyrosine.FunctionThe purpose of a low protein diet is to prevent
worsening of kidney or liver disease. The diet is effec-
tive because it decreases the stress on the kidney or
liver.KEY TERMS
Kidney disease —Most kidney diseases cause the
kidneys to lose their cleaning ability. Damage to
the kidneys may happen quickly because of injury
or poisoning, but most kidney diseases destroy the
kidneys slowly and silently over many years. The
two most common causes of kidney disease are
diabetes and high blood pressure.
Liver disease—Refers to any disorder of the liver. The
liver is a large organ in the upper right abdomen that
aidsindigestionandremoveswasteproductsfromthe
blood. Liver disease includes the following condi-
tions: Cirrhosis, or scarringof the liver, inflammation
(hepatitis) from infectious (hepatitis B, hepatitis C) or
non-infectious causes (chemical or autoimmune hep-
atitis), umors, benign and malignant (liver cancer),
andmetabolicdisorders.Alcoholabuseisoneleading
cause of liver disease. Infections, poisons, and inher-
ited (genetic)conditions can also cause diseases of the
liver.Low-protein diet