title: Have recommended protein and phosphate intake recently changed in maintenance hemodialysis?
abstract: The protein requirements recommended by international guidelines are uncommonly met in many dialysis patients. Recent large scale epidemiological studies have shown that survival impairs only when protein intake decreases below 0.9 g/kg body weight/day, and patients survival is highest for a protein intake comprised between 1.0 and 1.4 g/kg body weight/day. In case of inflammation, protein intake is frequently decreased by anorexia, however artificial nutritional support (either orally or intravenously) is able to improve nutritional status. Concerning phosphate intake, whereas increasing protein intake will slightly augment serum phosphate, the strongly observed beneficial survival benefit largely overcomes the serum phosphate increase risk. Finally, new dialysis techniques and/or membranes should be adequately assessed for their consequences on patients' nutritional status since there is a theoretical risk of increased nutrient losses.
authors.affiliation: Department of Nephrology, Hospital Edouard Herriot, place d’Arsonval, Lyon, France. denis.fouque@chu-lyon.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.forename: Solenne
authors.initials: S
authors.lastname: Pelletier
authors.forename: Fitsum
authors.initials: F
authors.lastname: Guebre-Egziabher
mesh_terms: D004044:Dietary Proteins / Q000008:administration & dosage* / Q000378:metabolism; D002149:Energy Intake; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D009751:Nutritional Requirements; D018529:Nutritional Support; D010710:Phosphates / Q000008:administration & dosage* / Q000097:blood; D006435:Renal Dialysis
chemical_list: D004044:Dietary Proteins; D010710:Phosphates