Percorsi pratici per intraprendere un programma di dialisi monosettimanale combinato con una nutrizione ipoproteica personalizzata

Piergiorgio Bolasco; Stefano Murtas; Gabriella Concas; Andrea Galfré

doi:10.33393/gcnd.2018.591

Authors

Piergiorgio Bolasco Già Direttore della S.C. Territoriale di Nefrologia e Dialisi ASL di Cagliari, Membro del Gruppo di Studio sul trattamento conservativo della insufficienza renale cronica della Società Italiana di Nefrologia
Stefano Murtas S.C. Territoriale di Nefrologia e Dialisi ASL di Cagliari, Cagliari
Gabriella Concas S.C. Territoriale di Nefrologia e Dialisi ASL di Cagliari, Cagliari
Andrea Galfré S.C. Territoriale di Nefrologia e Dialisi ASL di Cagliari, Cagliari

DOI:

https://doi.org/10.33393/gcnd.2018.591

Keywords:

Combined Diet Dialysis Program, once-weekly dialysis, diet program

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).