genitourinary disorders
Medical Aspects of Long Term Renal Replacement Therapy
Diet
Diet should be carefully controlled. Generally, hemodialysis patients tend to be anorexic and should be encouraged to eat a daily diet of 35 kcal/kg ideal body weight (in children, 40 to 70 kcal/kg/day depending on age and activity). Daily sodium intake should be limited to 2 g (88 mEq [88 mmol]), potassium to 2.3 g (60 mEq [60 mmol]), and phosphate to 800 to 1000 mg. Fluid intake, inclusive of the fluids contained in food, is limited to 1000 to 1500 mL/day and monitored by measuring weight gain between dialysis treatments. Patients undergoing peritoneal dialysis need a protein intake of 1.25 to 1.5 g/kg/day (compared with 1.0 to 1.2 g/kg/day in hemodialysis patients) to replace peritoneal losses (8.4 +/- 2.2 g/day). Survival is best among patients (both hemodialysis and peritoneal dialysis) who maintain a serumalbumin>3.5 g/dL (35 g/L); serumalbuminis the best predictor of survival in these patients. 