Protein requirements in maintenance hemodialysis

Protein requirements in maintenance hemodialysis patients are still unclear. Based on nitrogen balance studies and different analyses of protein and amino acid metabolism, the recommendations until recently were 1 g/kg of body weight, primarily of high biological value protein. According to the results of controlled long-term studies the 1 g recommendation now seems too low. The paper reports on the results of a controlled study undertaken to define protein requirements. The effect of supplementation with a special protein mixture is studied on the basis of 1 g of protein per kilogram of body weight intake and about 20 hr standard dialysis per week. The results suggest that 1.2 g of protein per kilogram of body weight primarily of high biological value protein and 35 kcal/kg of body weight should be prescribed for dialysis patients. In case of complications (bleeding, infection, and other stress situations) additional supplements are necessary.