Protein intake does not depend on the dose of dialysis delivered—provided Kt/V is adequate

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Abstract
A link between malnutrition and the dialysis dose has been recently postulated on the basis of the direct relationship between Kt/V and nPCR and an increase in dialysis therapy has been also proposed in malnourished patients or when nPCR is less than 1 g/kg b.w., but the clinical meaning of such a relationship is unclear. Both dietary protein intake and nPCR were simultaneously determined in a selected population of 35 well-dialysed patients (Kt/V>0.8) and were related to the delivered dialysis dose. No relationship was found between measured Kt/V (1.10 ± 0.20) and dietary protein intake (PI, 0.98 ± 0.20 g/kg) and similarly no relationship was evident between the dialysis dose and nPCR (0.99 ± 0.20 g/kg). Although the mean nPCR value was similar to that of protein intake, nPCR exceeded protein intake when PI was less than 1 g/kg b.w. Our results demonstrate that if the dialysis dose is adequate, protein intake is a dialysis—independent or patient—dependent variable. They also show that at least 0.9 to 1.0 g protein per kg b.w are required to maintain nitrogen balance even in well-dialysed patients.

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