Why are low protein diets not recommended in my country as an intervention for CKD?

The international guidelines (KDIGO 2012^[1]) now recommend protein intakes of about 0.8 grams per kilogram of bodyweight per day for CKD stages 3–5. However, these recommendations are similar to the recommended daily intake (RDA) values for the general population. Contrary to the international guidelines, the use of low protein diets as a dietary intervention in CKD management varies between countries and even within countries. In the U.S. and Canada, nutritional therapies are less often prescribed, probably due to the negative results of the Modification of Diet in Renal Disease (MDRD) study.^[2] In contrast, low protein diets are more commonly prescribed in Europe.^[3]