NUTRITION

Estimation of nutritional intake

Dietitians can estimate intake via 24-h recall or diaries to compare against the guideline targets for protein, energy, and electrolytes, identifying gaps for personalized medical nutrition therapy n hemodialysis patients with PEW or risk (Ikizler et al., 2020, Fiaccadori et al., 2021)

Protein intake

For metabolically stable hemodialysis patients, the target for protein is 1.0–1.2 g/kg/day ideal body weight.

Energy intake

Prescribe 25–35 kcal/kg/day (higher end for undernourished), adjusted for age/activity; KDOQI 2020 emphasizes energy adequacy to spare protein and improve outcomes in CKD stages 3–5D

Potassium and Phosphate

Individualize to serum levels (potassium 2–4 g/day, phosphate 800–1000 mg/day), prioritizing nutrient-dense foods, leaching, and binders over restriction; aligns with KDOQI 2020 electrolytes (Ikizler et al., 2020)guidance and KDIGO CKD-MBD [(2017)

Fluids

Text: Tailor to urine output +500–1000 mL/day (IDWG <3–5% dry weight); KDOQI 2020/HD guidelines stress thirst counseling to balance hydration, BP, and sessions. Salt intake must also be considered when supporting patients with fluid restrictions.