What is the recommended daily protein intake for an adult with CKD stage 4 not on dialysis?

• A. Approximately 0.6-0.8 g/kg/day
• B. 0.9-1.1 g/kg/day
• C. 1.2-1.5 g/kg/day
• D. 0.4-0.6 g/kg/day

Answer: (A)

In CKD stage 4 not on dialysis, a modest protein intake helps balance the need to limit nitrogenous waste with the risk of malnutrition. The kidneys are significantly impaired, so restricting protein reduces urea buildup and slows uremic symptoms while still preserving nutritional status if calories are adequate. Approximately 0.6–0.8 g of protein per kilogram of body weight per day is the recommended range. Consuming more than this (for example, around 0.9–1.1 or 1.2–1.5 g/kg/day) would add to the waste burden on the now-compromised kidneys. Conversely, consuming too little (0.4–0.6 g/kg/day) risks protein-energy malnutrition and loss of lean body mass. In practice, a dietitian individualizes this plan, ensuring sufficient calories to spare protein and close monitoring of nutritional status.