Chapter 12 The Aging Kidney and Renal Disease

TABLE 12.2 Daily Nutrient Recommendations for Chronic Kidney Disease Nutrient

Chronic Kidney Disease Stage 4 Hemodialysis

Protein (g/kg)

Energy (kcal/kg)

0.6–0.8 23–35

1.2 ≥ 50% HBV protein

≥ 60 y of age: 30–35

< 60 y of age: 35

Peritoneal Dialysis

1.2–1.3 ≥ 50% HBV protein

≥ 60 y of age: 30–35

< 60 y of age: 35

Include dialysate kcal

Fluid (mL)

Sodium (g)

Potassium (g)

No restriction < 2,400 mg Usually

unrestricted unless

individual’s serum levels are high

Phosphorus 10–12 mg/g protein or

800–1,000 mg/d

Calcium (g)

Other

minerals and

vitamins

< 2, including binder load

DRI: complex and vitamin C; individualize vitamin D, iron, zinc

10–12 mg/g protein or

800–1,000 mg, adjust for protein

< 2, including binder load

C: 60–100 mg B-6: 2 mg Folate: 1 mg B-12: 3 μg RDA: others Vitamin E: 15 IU Zinc: 15 mg Individualize iron, vitamin D

Source: Data are from references 7–10.

10–12 mg/g protein or

800–1,000 mg, adjust for protein

< 2, including binder load

Same as

hemodialysis but may need 1.5–2 mg of vitamin B-1 because of dialysis loss

0.8–1.5

DRI, may need additional Vitamin D

0.2–1.5

DRI, may need additional Vitamin D

DRI; supplement as needed

DRI

Output plus 1,000 mL

24

2–3 or 40 mg/kg Adjust to serum levels

Maintain balance

2–3

Monitor fluid balance

2–4

Adjust to serum levels

2–4 Unrestricted 2–4 Unrestricted 2–4 with hypertension

Unrestricted unless

hypertensive 1.3–2 30–35

175

Post-transplant, Postoperative

Post-trans- plant, Chronic

0.8–1

Adjust calories to maintain body weight