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DKD Protein Intake — ESENeph MCQ

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HardDiabetic Kidney DiseaseDKD Protein IntakeESENeph

A metabolically stable 72-kg adult with progressive CKD G4, no diabetes and no evidence of protein-energy wasting asks about protein intake. Which daily target best reflects KDIGO guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Approximately 58 g/day, with avoidance of sustained intake above about 94 g/day

Explanation lettering: E = shown as A · D = shown as C · C = shown as D · A = shown as E

D is correct. A target of 0.8 g/kg/day gives 57.6 g/day for a 72-kg adult. KDIGO also advises avoiding high protein intake above 1.3 g/kg/day in adults with CKD at risk of progression; here that upper level is 93.6 g/day. The calculation must be interpreted clinically: frailty, sarcopenia, intercurrent illness and evidence of protein-energy wasting may make restriction inappropriate. Severe unsupervised restriction is hazardous, while routine high-protein intake may increase intraglomerular pressure and conflict with kidney-protective dietary advice.

Reference: KDIGO 2024 CKD guideline: https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf