DIET IN RENAL DISEASE Restricting protein intake in CKD can delay progression of the disease and reduce adverse cardiovascular effects and uraemia.12 While those with CKD generally suffer from low serum albumin, this reduction is probably more due to loss of protein through the damaged kidneys, metabolic acidosis, dialysis and on-going infl ammation, rather than malnutrition.12 A low-protein diet reduces production of nitrogenous wastes, reducing renal damage, infl ammation and gastrointestinal symptoms. Low-protein diets are also associated with reduced sodium, phosphate and acid intake, reducing development of hypertension, hyperphosphataemia and acidosis. Very low protein diets must be accompanied by supplements of essential amino acids and ketoacids.