Abstract: 【Abstract】Purpose The K/DOQI nutrition guidelines recommend that maintenance hemodialysis (MHD) patients should have a dietary protein intake (DPI) of at least 1.2 g/kg/day to avoid malnutrition. However, there were conclusions different from this recommendation from many studies in recent years. In this study, we compared the nutritional and clinical status in MHD patients using different DPI to discuss the most appropriate protein intake and provide the basis for nutritional therapy in MHD patients. Methods A total of 189 MHD patients treated in our dialysis center and with stable dietary were enrolled in this study. The patients were asked to record their diet in detail for 3 days, and the records were analyzed by dietitians using Keto nutritional assessment software. Nutritional evaluation including subjective global assessment (SGA), anthropometric and laboratory examinations were collected. Results In the 189 patients, 126 patients with DPI ≥0.8 g/(kg·d) were selected and divided into three groups: ①DPI >0.8 g/(kg·d) and ＜1.0 g/(kg·d), n= 43; ②DPI >1.0 g/(kg·d) and ＜1.2 g/(kg·d), n=61; ③DPI ≥1.2 g/(kg·d), n=38. Dietary energy intake was lower than the recommendation in all 3 groups, and the proportion of nutrient intake including protein, carbohydrate and lipids was similar among the three groups. SGA, anthropometric data and laboratory examinations including hemoglobin, albumin and total cholesterol showed no differences among the three groups. However, BUN, serum creatinine, serum phosphate and acidosis increased along with the increase of DPI, and were significantly different among the three groups. Conclusion DPI between 0.8 and 1.2 g/(kg·d) can maintain better nutritional status and ameliorate hyperphosphatemia and acidosis in Chinese MHD patients using low-flux dialyzers.

Key words: Maintenance hemodialysis, Nutritional status, Dietary protein intake