Based on this information, the CDA (12) recommends that in
people with CKD, intakes should be targeted to the RDA of 0.8 g/kg
BW/day. Both the Academy of Nutrition and Dietetics (AND) (19)
and the Kidney Disease Outcomes Quality Initiative (KDOQI) (6)
guidelines also recommend intakes in the 0.8 to 0.9 g/kg BW/day
range for those with CKD and diabetes. Counselling to avoid underconsumption
or excessive consumption of protein is recommended.
Excessive intakes are generally defined as a diet that
contains 20% or more total calories derived from protein. The 2012
KDIGO (24) guidelines recommend that protein intake should be
maintained at 0.8 g/kg BW/day with avoidance of intakes above
1.3 g/kg BW/day for those individuals at risk for progression. Upon
review of the evidence, the KDIGO working group concluded that in
CKD with diabetes, there was no convincing evidence that longterm
low protein intakes (