| [ Summary ] |
Both macronutrients and micronutrients are indispensable for maintaining physiological function of the body. Dialysis patients should ingest sufficient amounts of protein and energy from their foods to prevent malnutrition and wasting conditions. Sodium intake is associated with interdialytic weight gain. Thus, adequate restriction of sodium intake is necessary for circulatory stability, and appropriate blood pressure control. Phosphate is a major contributor of chronic kidney disease-mineral and bone disorders and hyperphosphatemia associated with worse outcomes. Phosphorus exhibits a specific kinetic in the body, or a pseudo-one compartment model, and can be removed in a time-dependent manner. Moreover, the amounts of phosphorus in foods are highly correlated with amounts of protein. Protein intake might be prioritized over phosphate intake for better survivals of patients. Patients should take phosphate binders to control serum phosphate levels when they receive conventional dialysis treatments. Older patients with reduced appetites can experience hypokalemia from uniform removal of potassium during dialysis sessions. Finally, water-soluble vitamins are targets of removal by hemodialysis treatments. Several studies demonstrated that appropriate supplementation of these vitamins was associated with better survival, although, a guideline which indicates concrete dosage of supplementation has not yet been published. |