The 2025–2030 Dietary Guidelines for Americans: A Kidney-Safe Perspective

The 2025–2030 Dietary Guidelines for Americans (DGA) prioritize minimally processed foods and discourage highly processed foods, refined carbohydrates, added sugars, and sugar-sweetened beverages. For chronic kidney disease (CKD), several DGA messages are concordant with kidney-protective care, but others are not. Sodium restriction, avoidance of highly processed foods, added-sugar reduction, and emphasis on minimally processed plant foods align with KDOQI and KDIGO guidance. However, the DGA population protein target of 1.2–1.6 g/kg/day conflicts with the KDOQI 0.6–0.8 g/kg/day recommendation for metabolically stable adults with non-dialysis CKD G3–G5. Routine full-fat dairy messaging, unrestricted potassium-rich plant foods, and permissive saturated-fat guidance also require modification in advanced CKD. This Perspective proposes that the DGA be translated, not adopted wholesale, in CKD care through a three-step "adopt, individualize, override" framework, and that renal medical nutrition therapy remain central to stage-specific implementation.