title: Low-dose dialysis combined with low protein intake can maintain nitrogen balance in peritoneal dialysis patients in poor economies .
abstract: OBJECTIVE
  Due to limited economic conditions, we tried to provide "fitted" dialysis doses instead of the doses recommended by the international guidelines to the individual patients. In the present cross-sectional study, we studied the dialysis adequacy and nutritional status of 5 peritoneal dialysis patients who had a low dialysis dose (2 bags, 4,000 mL/day).
  
  
  METHODS
  The 3-day dietary records were reviewed to calculate patients' energy, protein, and nitrogen intake (NI). The nitrogen removal (NR) from urine and dialysate was measured by Kjeldahl technique. Fecal nitrogen was estimated as 0.0155 g/kg/day. Subjective global nutritional assessment was used to evaluate the nutritional status.
  
  
  RESULTS
  Among the 5 patients, 1 male and 4 female, mean age was 59 (42 - 81) years, dialysis duration 43 (33 - 74) months, body weight 51.05 ± 2.53 kg. The mean dietary protein intake was 0.66 g/kg/day, total weekly Kt/v was 1.25 (residual kidney Kt/v was 0.09), and total daily fluid removal was 699 mL. However, they achieved lower-level neutral nitrogen balance (NI 5.26 ± 0.93 g/day vs. NR 5.33 ± 0.81 g/day, N balance -0.07 ± 0.60 g/day). All of them maintained good nutritional status (SGA "A") without symptoms of nitrogen retention (serum urea 22 ± 4.18 mmol/L).
  
  
  CONCLUSIONS
  Lower dialysis dose with lower daily protein intake can achieve a lower-level nitrogen balance and does not lead to malnutrition. It may be an effective approach to solve the dialysis problem for the economically week population in China, especially for people with a smaller body size with lower transport membrane. .
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Su
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Xin-Hong
authors.initials: XH
authors.lastname: Lu
authors.forename: Sha
authors.initials: S
authors.lastname: Ma
authors.forename: Wen
authors.initials: W
authors.lastname: Tang
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D002681:China; D003430:Cross-Sectional Studies; D015314:Dialysis Solutions; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism*; D009752:Nutritional Status; D010530:Peritoneal Dialysis / Q000379:methods*; D014508:Urea / Q000097:blood
chemical_list: D015314:Dialysis Solutions; D004044:Dietary Proteins; D014508:Urea; D009584:Nitrogen