Diet therapy in patients receiving peritoneal dialysis.

The guidelines in US and Japan recommend CAPD patients to have protein intake twice that of CKD patients before the start of dialysis therapy. However, it is very difficult for patients, and may encourage the deterioration of residual renal function (RRF). We propose 0.8 g/kg body weight/day of protein intake for CAPD patients who still urinate, because it maintained RRF significantly in our study of 24 Japanese patients. Also in our investigation in 93 patients, almost all patients did not satisfy their recommended amount in energy (92.4%), protein (91.3%), and calcium (90.3%) intake. For the patients, it is hard to change their life-style, especially dietary habits. We have to consider the improvement of dietary guidelines which are suitable for individual patients, and the adaptation of behavior science to nutrition counseling.