Practical paths to undertake a one-week dialysis program combined with a nutrition personalized hypoproteics

Abstract

The aim of this article is to provide detailed information to nephrologists on how to apply the combined diet dialysis program (CDDP) in selected patients. Patients are evaluated by urea nitrogen appearance, which allows the sustainability and compliance of patients on 0.6 g/kg per day low-protein diet to be verified by calculating the protein catabolic rate at a metabolic steady state. The combined action of nutrition and less frequent hemodialysis may preserve residual renal function with a further chance of achieving greater excretion of the protein-bound uremic toxins, thereby obtaining a positive phosphate balance. This paper describes all fundamental steps and calculations, although a greater clinical commitment is required to achieve a tailored therapeutic protocol such as Combined Diet Dialysis Program (CDDP).