Protein intake seems to respond to increases in Kt/V despite baseline Kt/V greater than 1.2.
The nutritional status is a strong predictor of outcome in hemodialysis patients. Adequate delivery of dialysis is necessary for hemodialysis patients to maintain their protein nutrition. In general, a single-pool Kt/V of 1.2 has been considered adequate dialysis. We recently decided to maximize the blood flow during hemodialysis in all of our patients; this enabled us to increase the dose of delivered dialysis in those patients who were not initially utilizing their maximum blood flow. There were 18 patients who already received a Kt/V greater than 1.2. We were able to increase Kt/V even further in 10 of them, resulting in a significant increase in nPCR and a trend to increase serum albumin over the next 6 months of follow-up. The mean normalized protein catabolic rate (nPCR) and serum albumin remained unchanged in the remaining 8 patients whose Kt/V could not be increased. Our data provide evidence that protein intake in hemodialysis patients will increase with an increase in delivered dialysis above the level generally considered to be adequate.
Marcus
R G
RG
Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
Cohl
E
E
Uribarri
J
J
D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000379:methods; D012709:Serum Albumin / Q000378:metabolism*; D014508:Urea / Q000378:metabolism*
D004044:Dietary Proteins; D012709:Serum Albumin; D014508:Urea