For last week’s practice question, we quizzed participants on how much protein is recommended. 73% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it by clicking here.
AR is a 63-year-old with type 1 diabetes and mild hypertension. Their GFR is 41 mL/min/1.73m² and UACR is 312 mg/g and their BMI is 24. The provider asks you to instruct AR on a low-protein diet, since AR is in stage 3 CKD. What is your best response?
- A. Agree to provide education for AR low protein (0.6 -0.8 g/kg/day) to slow kidney disease progression.
- B. Reframe and suggest protein intake of about 0.8 g/kg/day as supported by ADA guidelines.
- C. Suggest AR eliminates most protein sources and focus primarily on fiber, carbohydrates and fats.
- D. Reinforce that a protein intake of 1.3 g/kg/day is warranted to prevent sarcopenia and maintain muscle mass.
Getting to the Best Answer
Answer A is incorrect. 16.88% chose this answer, “Agree to provide education for AR low protein (0.6 -0.8 g/kg/day) to slow kidney disease progression.” This answer is incorrect. Very low-protein diets (<0.6 g/kg/day) have not consistently shown additional renal benefit and may increase the risk of malnutrition, sarcopenia, and frailty, especially in older adults like AR (age 63).
Answer B is correct. 73.05% of you chose this answer, “Reframe and suggest protein intake of about 0.8 g/kg/day as supported by ADA guidelines.” This answer is correct. GREAT Job! People with stage 3 CKD need adequate plant-based or animal protein intake to maintain muscle mass and optimize health and well-being.
Answer C is incorrect. About 2.52% of respondents chose this: “Suggest AR eliminates most protein sources and focus primarily on fiber, carbohydrates and fats.” This answer is incorrect. Since people with diabetes need to consume adequate amounts of either plant-based on animal protein (~0.8 g/kg/day) to maintain muscle mass and optimize health.
Finally, Answer D is incorrect. 7.56% chose this answer, “Reinforce that a protein intake of 1.3 g/kg/day is warranted to prevent sarcopenia and maintain muscle mass.” This answer is incorrect. Higher protein intake (>1.3 g/kg/day) may increase intraglomerular pressure and albuminuria, potentially accelerating kidney decline.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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