Whey protein is one of the most popular protein supplements used worldwide to build muscle. It also modulates cellular metabolism and helps in weight loss by keeping you fuller for longer.
But anyone who has experienced kidney disease as a patient or caregiver has heard how high protein is detrimental to diseased kidneys. So, does that mean using such protein supplements could lead fitness-conscious individuals to acquire Chronic Kidney Disease? Let’s investigate!
WHAT IS WHEY PROTEIN?
The liquid that separates out while deriving natural cottage cheese & yoghurt from raw milk is termed Whey.
Whey is naturally comprised of (1):
While natural Whey is quite nutritious, as you can see in the table above, the percentage of protein content (0.6%) is not stellar in terms of protein supplementation that consumers usually desire.
As per the US FDA norms, protein content in commercial whey protein powders must exceed 25% of the net weight of the product. Hence, commercial platforms filter, refine and spray-dry Natural Whey to obtain formats with FDA-approved protein content relative to the net weight of the product. These are:
WHEY PROTEIN CONCENTRATE
70-80% protein, lactose, fat and minerals in milk
WHEY PROTEIN ISOLATE
90% protein, less lactose and fat, but poor in mineral content This is a good option for lactose intolerant individuals
WHEY PROTEIN HYDROLYSATE
A pre-digested format for easy absorption into the blood-stream
WHAT QUALIFIES AS HIGH PROTEIN INTAKE?
For healthy adults, the recommended daily intake of Protein stands at 0.8 grams per kilogram (kg) of body weight (2) for a 2500 and 2000 calorie-diet for men and women respectively. (3) If the value of total protein intake exceeds 2.0 grams/kg body weight per day, it is termed as “High Protein” intake. (4)
PROTEIN SUPPLEMENTS & KIDNEYS
High protein consumption does affect the normal functioning of kidneys by raising the blood pressure within them. In other words, kidneys need to filter more blood per unit time than otherwise. This is precisely why members with kidney disease who are not on Dialysis, are prescribed a protein-restricted diet. This is to avoid burdening already unwell kidneys with work overload.
1. FOR HEALTHY INDIVIDUALS
There is no published research evidence to date, that suggests kidney damage as a direct complication of Whey protein supplementation by healthy individuals, especially when done for shorter periods.
However, since CKD symptoms appear in very advanced stages, you may find case reports of people with a history of use of Protein Supplements developing kidney disease. This, when in reality they might have had an underlying kidney disease all along. Such reports concluding Whey protein as a “cause for kidney failure” are more likely to be potentially misleading.
Interestingly, in healthy individuals leading a moderately active lifestyle, high protein diets that conform to general fitness needs (not exceeding 280 grams of total protein intake per day) appear to have a favourable effect on combating the known risk factors for chronic kidney disease (5) namely Hypertension (6), Obesity (7) and High Blood Sugar in Diabetes mellitus without kidney complications (8).
2. FOR PATIENTS WITH KIDNEY DISEASE
Positive effects of high protein intake on CKD risk factors are offset by a compromised filtration capacity in kidney patients. In such a scenario, high protein consumption is likely to hasten kidney damage progression. Naturally, this weighs unfavourably on the overall clinical outcome. However, for patients on Dialysis, high protein intake is necessary despite the risks as explained below.
HOW DOES THIS APPLY TO DIFFERENT SCENARIOS?
1. If you know for sure that you have healthy kidneys
Go ahead with your protein-supplemented, fat-restricted fitness diet as usual. However, see to it that you don’t go overboard. Avoid taking enormous amounts of protein on a daily basis over years. Your kidneys are only “human”! Maintaining a “fitness diary” of sorts could help you monitor your approximate daily nutritional intake.
2. If you are unsure about your kidney health status
So you want to build some lean muscle and wish to start Whey protein supplementation, but are unsure about your kidney health status? Clear your confusion with just get a simple Urine Routine Test. A dipstick evaluation of the urine sample to look for protein, blood and glucose can help your doctor understand if your kidneys need medical care & protein-restriction or not.
3. If you are a known case of kidney disease but not on dialysis
In such a case, your medical care team will advise you to follow a protein-restricted diet. Make sure you follow it to the tee. Ask your dietitian if you can take Whey protein powder (and in what quantity) after adjusting it with your protein intake from regular food. Your dietitian would advise you on this matter according to the stage of your kidney disease, whether you are on dialysis or not, your age, physical activity and presence of other medical conditions (co-morbidities).
4. If you are a CKD patient already on Dialysis
You will be going for a protein-enriched diet to compensate for the protein loss that accompanies the procedure. This is true especially if you are on Peritoneal Dialysis. (9) This is necessary to avoid fatigue, chances of infection and undesirable weight loss that normally results from protein loss. Whey Protein can be a great source of high-quality protein supplementation in such a scenario. (10)
5. If you have had a Kidney Transplant
Following a kidney transplant, your protein requirement will vary with passing time depending on how well your new kidney functions. For the first 6 weeks after transplant, your renal dietitian may advise you to ramp-up your protein intake. You may incorporate a calculated amount of Whey Protein Powder in accordance with your kidney function and body weight. This is to help in surgical wound healing. It is imperative that you strictly follow all nutrient guidelines that your renal dietitian sets for you post-transplant. This will help your graft (new kidney) to settle well in your body. In the longer term, even if graft kidney shows steady clinical parameters within normal limits, it is generally advised to not go for Whey protein supplementation or exceed 1.5 grams of protein intake per kilogram of body weight per day. (11)
Weight gain is a common side effect of the anti-rejection medicines that you will be taking after transplant. For weight management, always consult your medical care team for the plan best-suited to your health needs.
Please do not go for any unsupervised fitness diet without consulting your medical care team at any cost.
TAKE HOME MESSAGE
For fitness-conscious individuals who have never had a kidney problem and do not experience any relevant symptoms, up-to-date research evidence suggests that Whey Protein supplementation should not pose a problem. However, the daily protein intake must not exceed 280 grams irrespective of your body weight. In addition, it is best to incorporate such supplements for short stretches of time.
If you have early Kidney Disease, are on Dialysis or have had a Kidney Transplant, consult your Renal Dietitian on whether Whey Protein supplements are safe for you. Avoid unsupervised fitness diet regimens at all costs.
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