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

BACKGROUND: A link between malnutrition and the dialysis dose has been recentlypostulated on the basis of the direct relationship between Kt/Vand nPCR and an increase in dialysis therapy has been also proposedin malnourished patients or when nPCR is less than 1 g/kg b.w.,but the clinical meaning of such a relationship is unclear. DESIGN: Both dietary protein intake and nPCR were simultaneously determinedin a selected population of 35 well-dialysed patients (Kt/V>0.8)and were related to the delivered dialysis dose. RESULTS: 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 dialysisdose and nPCR (0.99 ± 0.20 g/kg). Although the mean nPCRvalue was similar to that of protein intake, nPCR exceeded proteinintake when PI was less than 1 g/kg b.w. CONCLUSION: Our results demonstrate that if the dialysis dose is adequate,protein intake is a dialysis—independent or patient—dependentvariable. They also show that at least 0.9 to 1.0 g proteinper kg b.w are required to maintain nitrogen balance even inwell-dialysed patients.