A client with end-stage kidney disease requires dialysis three times weekly. Which statement about daily protein intake is most accurate?

A client with end-stage kidney disease requires dialysis three times weekly. Which statement about daily protein intake is most accurate?

• A. The intake of protein should be increased to stimulate the kidney's nephrons function.
• B. The intake of protein should be decreased due to nitrogenous waste buildup.
• C. The intake of protein should be increased due to its loss through the filter membrane.
• D. The intake of protein should be decreased due to the progressively failing function of the kidney.

Answer: (B)

The main idea is that protein needs rise with dialysis because the process itself removes amino acids and small proteins from the blood. Dialysis membranes can leak some protein into the dialysate, so dietary protein must be increased to replace these losses and maintain a positive nitrogen balance. This helps prevent malnutrition and muscle wasting in someone undergoing regular dialysis. A common guideline for adults on dialysis is about 1.2 to 1.3 grams of protein per kilogram of body weight per day. Decreasing protein to reduce nitrogenous waste isn’t appropriate here, since dialysis handles waste removal and the patient’s nutrition would suffer without sufficient protein. In contrast, not providing enough protein would worsen malnutrition despite the dialysis.

The main idea is that protein needs rise with dialysis because the process itself removes amino acids and small proteins from the blood. Dialysis membranes can leak some protein into the dialysate, so dietary protein must be increased to replace these losses and maintain a positive nitrogen balance. This helps prevent malnutrition and muscle wasting in someone undergoing regular dialysis. A common guideline for adults on dialysis is about 1.2 to 1.3 grams of protein per kilogram of body weight per day.

Decreasing protein to reduce nitrogenous waste isn’t appropriate here, since dialysis handles waste removal and the patient’s nutrition would suffer without sufficient protein. In contrast, not providing enough protein would worsen malnutrition despite the dialysis.