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!
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