Proteins and Your Kidneys-Clearing Up The Confusion

Almost every week, I hear some version of this concern—from patients, friends, or family:

“But won’t eating more protein damage my kidneys?”

This almost always comes up when I ask someone to calculate how much protein they are actually eating each day. For many, the number is surprisingly low. The fear that protein harms kidney function is widespread, but is it actually supported by evidence?

Let’s start with the basics. The Recommended Dietary Allowance (RDA) for protein is 0.8 grams per kilogram of body weight per day, or about 0.36 grams per pound, which translates to roughly 52 grams per day for someone weighing 65 kilograms (143 pounds). However, the RDA only represents the minimum amount needed to prevent deficiency, not the amount required for optimal health.

Is that amount enough for optimal health?

In a widely cited 2016 article titled “Protein ‘requirements’ beyond the RDA: implications for optimizing health,” researchers concluded:

“Current evidence indicates that intakes in the range of at least 1.2 to 1.6 g/kg/day of high-quality protein are a more ideal target for achieving optimal health outcomes in adults.”

Most of us are not just looking to avoid deficiency—we’re aiming to stay active, independent, and resilient. That’s why I typically recommend 1 to 1.2 grams per kilogram of body weight per day for adults who are not physically active. That works out to roughly 0.45 to 0.54 grams per pound, or about 65 to 78 grams per day for someone weighing 65 kg (143 lbs)—equivalent to about 2.3 to 2.8 ounces of protein per day. You need more protein if you are physically active.

What about kidney function in people who eat more protein?

Several studies have compared people eating 1.5 grams of protein per kilogram per day (or more than 100 grams of protein daily) with those consuming less protein to assess whether it affects kidney function. The results are reassuring:

These studies did not find any harm to kidney function in healthy individuals who consumed more protein.

What about people with kidney disease?

The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines—the international gold standard used by kidney specialists—were updated in 2024 and now recommend the following:

• 0.8 g/kg/day for adults with CKD who are not on dialysis
• Avoid high protein intake (>1.3 g/kg/day) only in individuals at risk for progression (this threshold is still higher than most expert recommendations for the general public)
• Encourage higher protein intake in older adults with frailty or muscle loss

Why do we need protein?

1. It helps build and preserve muscle mass
2. It does not raise blood glucose levels like carbohydrates do.
3. It promotes satiety, helping reduce cravings and mood swings.
4. It supports bone strength—bones are made of more than just calcium
5. It helps maintain weight loss and preserve lean mass during calorie restriction
6. Older adults need more protein, not less.

A note about vegetarian protein sources.

While legumes like chickpeas and lentils do contain protein, they also come with a significant carbohydrate load. They also do not contain all the amino acids. Many people believe they’re eating high-protein meals when, in reality, they are consuming more carbohydrates than protein. This matters if you’re managing diabetes or metabolic dysfunction.

Do you need protein supplements?

For some people—especially older adults, vegetarians, or those with smaller appetites—hitting protein targets through food alone can be challenging. In those cases, protein supplements can help fill the gap.

Protein isn’t something to avoid. It’s something to prioritize.

For most people, including many with early-stage kidney disease, it is not only safe but essential.

What does 65–78 grams of protein look like on your plate?

After my last email on protein and kidney health, many of you asked a very practical follow-up question:

“What do these protein numbers mean in terms of real food? What should I actually eat each day?”

That’s a great question, because saying you need 1 to 1.2 grams of protein per kilogram of body weight per day makes sense on paper, but it doesn’t help much when you’re standing in your kitchen wondering what to eat.

So let’s break it down.

If you weigh 65 kilograms (143 pounds), your daily protein target is 65 to 78 grams. That is:

• 0.45 to 0.54 grams of protein per pound of body weight
• Around 2.3 to 2.8 ounces of pure protein, or
• Roughly 0.14 to 0.17 pounds of pure protein

These values refer to protein content, not the total weight of the food. Here’s how you can meet those numbers in a day, whether you eat meat or follow a vegetarian foodstyle (Borrowing my friend and associate Dr. Iyer’s expression)

Non-Vegetarian Example (Target: 65–78g protein/day)

Breakfast:

• 3 whole eggs → ~21g protein

Lunch or Dinner (Choose one):

• 150g steak (approx. 5.3 oz) → ~38–40g protein
• 2 medium chicken drumsticks (approx. 5–6 oz, cooked) → ~32–34g protein
• 150g cooked fish (approx. 5.3 oz)
• Salmon → ~34g protein
• Rohu/Catla (Indian carp) → ~28–30g protein

Optional (to meet the upper end of the range):

• ½ to 1 scoop whey protein isolate → 10–20g protein, 0–2g carbohydrates

Day’s Total: ~65–78g protein

Beef jerky (28g or 1 oz) can also be a useful addition, providing approximately 25g of protein; however, be sure to read the label carefully. Look for minimal ingredients, no added sugar, and no artificial preservatives.

Vegetarian Example (Target: 65–78g protein/day)

Includes a protein supplement

Breakfast:

• 1 scoop whey protein isolate → 20–25g protein, 0–2g carbohydrates

Lunch (Choose one):

• 150g paneer (approx. 5.3 oz) → ~37g protein, ~5.3g carbohydrates
• 250g firm tofu (approx. 8.8 oz or 1¼ cups diced) → ~43g protein, ~7g carbohydrates

Although paneer (Indian cottage cheese) has more protein per 100 grams, people often eat smaller portions due to its rich texture. Tofu is typically eaten in larger amounts, and as a result, a standard tofu-based meal can offer equal or greater protein with very modest carbohydrate content.

Dinner:

• 1 scoop whey protein isolate → 20–25g protein, 0–2g carbohydrates
• Optional: ¾ cup cooked moong lentils → ~7g protein, ~20g carbohydrates
• Or 100 grams (3.5 ounces) of boiled kidney beans → Protein: 8.7 grams, Carbohydrates: 22.8 grams

Day’s Total: ~65–78g protein

The carbohydrate content remains low unless legumes, such as lentils or beans, are included.

These examples provide a clear, real-world illustration of what it takes to meet your daily protein requirements. Whether you’re focused on maintaining muscle, supporting metabolic health, or aging well, planning your protein intake, just like you would any important nutrient, is worth the effort. Most people need a protein supplement to meet their higher protein requirements. You will need other protein supplements if you are sensitive to whey protein.

References:

1. Phillips, Stuart M., Stéphanie Chevalier, and Heather J. Leidy. “Protein “requirements” beyond the RDA: implications for optimizing health.” Applied Physiology, Nutrition, and Metabolism 41.5 (2016): 565-572.
2. Devries, Michaela C., et al. “‘Changes in Kidney Function Do Not Differ between Healthy Adults Consuming Higher-Compared with Lower-or Normal-Protein Diets: A Systematic Review and Meta-Analysis.” The Journal of nutrition 148.11 (2018): 1760-1775.
3. Levin, Adeera, et al. “Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: known knowns and known unknowns.” Kidney international 105.4 (2024): 684-701

P.S. I had originally shared this content as part of two separate weekly emails. For those who missed them or would like to revisit both parts together, I’ve compiled the full version on a single page.