TOPIC DISCUSSION: Nutrition

If you wanted to know that the prescribed protein restricted diet is adhered to by your CKD patient, how would you go about figuring that out?

Concepts:
1- Nitrogen Balance = Nitrogen Intake - Urea Nitrogen Appearance Rate (i.e. 24hr urine urea nitrogen if in steady state) - Non Urea Nitrogen

2- Non Urea Nitrogen = 0.031g Nitrogen/kg body weight

3- If Nitrogen Balance = 0, then Nitrogen Intake = Urea Nitrogen Appearance Rate + Non Urea Nitrogen

Take the result (g Nitrogen/day) and multiple by 6.25 (since 16% protein in Nitrogen) to get g protein

Use these concepts for PD patients as well, where you take 24hour urine V x random urea Nitrogen (or 24hour urine Nitrogen if available) and add to dialysate volume and urea concentration of dialysate.

Fun with numbers!