A theoretical definition of minimal acceptable dialysis therapy

A theoretical definition of "minimal acceptable dialysis therapy" is that which: provides optimal sodium, potassium, hydrogen, and water homeostasis, optimal calcium and phosphorus homeostasis, and nontoxic concentration profiles for all other solutes which exhibit concentration-dependent toxicity normally controlled by renal excretion; results in maximal patient well-being and rehabilitation with minimal dialysis related morbidity; is sufficiently well-defined with respect to dose to be reliably prescribed for any individual patient which requires that, for all solutes of clinical importance, the kinetic behavior and closure of mass balance be verified for individual patients. Empirically, the minimum dose of dialysis (dialyzer urea clearance, treatment time and frequency) sufficient to result in mean predialysis BUN values of 80 mg/dl with documented dietary protein intake (DPI) greater than or equal to 1.0 g/kg/day and measured protein catabolic rate (PCR) equal to DPI has been shown to be acceptable with respect to currently achieved clinical outcome parameters.