About MDRD

• MDRD refers to a research study and series of clinical trials, the initial findings of which were published in the May 1993 Journal of the American Society of Nephrology, the world's premier kidney research publication. MDRD is an ongoing effort, and its most recent discoveries were published in the February 2009 edition of the American Journal of Kidney Diseases. As this is the most up-to-date research on the topic of low-protein diets and kidney disease, it should form the basis of your dietary model.
  
  The 2009 study published in the American Journal of Kidney Disease attempted to compare the effectiveness of two different dietary approaches to combating renal disease--a low-protein approach (0.58 g of protein per kilogram of weight per day) and a very low protein approach (0.28 g of protein per kilogram of weight per day). Under current dogma, you would expect that where a low protein approach is good for individuals with renal disease, a very low protein approach would be even better. However, the study concluded the exact opposite, finding that patients following the very low protein approach actually had an increased risk of death. Thus, a moderately restricted protein diet might be best for treating renal disease.
  
  

Establishing Your Baseline Protein Levels

• To implement your low-protein diet you want to closely mimic the study as closely as you can. Under the study, the low-protein group was using a daily intake of 0.58 g per kilogram of body weight. When converted into pounds, this is roughly 0.26 g of protein per pound of body weight. This means that if you are 200 pounds, you should be consuming no more than 52 grams of protein daily while on an MDRD-recommended low-protein diet. For optimal results, be sure to space your protein intake out evenly among all of your planned daily meals. Thus, if you are going to eat three major meals a day, each one should contain roughly 17 g of protein. Lean meats are your best bet for obtaining quality sources of protein--small servings of fish, chicken, turkey, and some red meats get you to your daily protein limit in the healthiest possible way.
  
  

Rounding Out Your Diet

• After calculating your protein intake, round out your diet to ensure that you are consuming adequate calories, vitamins, and nutrients. To do this, eat plenty of whole grains, fruits, and vegetables--have at least one serving of each with every meal. Finally, supplement your low-protein diet with plenty of healthy fats, like fish oil, avocados, and coconuts. This keeps your calories reasonably high so you do not inadvertently lose weight while on your low-protein diet.
  
  

Low-Protein Tips

• Remember that by curbing protein intake you also curb your daily caloric totals. Unless you are intending to lose weight, you want to "restore caloric balance" by replacing the missing calories from protein with additional calories from carbohydrates and healthy fats. A good way to do this is to reevaluate how you arrange your meals--whereas most individuals would plan to have meat as a main course and consider vegetables as a side dish, you should instead consider carbohydrates and healthy fats as your main course and treat meat as a side dish. Reversing your "normal" intake of proteins and carbs ensures that you do not unnecessarily and unintentionally restrict calories while on your low-protein diet.