Energy Requirements for Dialysis Patients

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Energy requirements to achieve neutral nitrogen balance in stable diabetic dialysis patients are similar to those of healthy non-diabetic adults (35kcal/kg body weight), with lower requirements for subjects over 65 years of age (30-35kcal/kg body weight) (19). Patients on CAPD receive part of their energy requirements from dialysate glucose (see below) (20).

If CAPD patients have difficulty in meeting their recommended dietary energy intakes due to early satiety, they should be encouraged to eat after 'drain-out' and to wait 20-30 min before commencing the next dialysate bag. Avoiding fluids at mealtimes can also improve appetite by minimising stomach distension. If energy requirements are not achieved despite dietetic input, nutritional supplements should be considered (21).

Table 15.3 A checklist for interpreting blood results of dialysis patients

Biochemistry (normal range)

Low

Good

Acceptable

High

Urea (mmol/l)

<20

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