The guideline addresses dietary modifications and lifestyle changes in CKD. The commentary work group concurs with most of these recommendations with the following caveat. The recommendation to maintain a body mass index (BMI) of 20-25 kg/m2 may be inappropriate for certain patients with CKD. Observational data suggest that the relationship be-tween BMI and risk of adverse outcomes in CKD may be different from that in the general popula-tion.34-36 Moreover, given the propensity for fluid retention in CKD, we thought that BMI may not accurately reflect body fat in this setting.37 In addi-tion, overly restrictive dietary prescriptions may diminish total caloric intake, markedly reduce protein intake, and result in malnutrition