The effect of urea kinetic modeling on the nutrition management of hemodialysis patients.

Urea kinetic modeling is a hemodialysis prescription technique that includes calculation of patients' protein catabolic rate (grams per kilogram body weight per day). This study compared the use of current guidelines alone with the integration of the urea kinetic modeling-derived protein catabolic rate and current guidelines for the nutrition assessment and management of 27 chronic renal failure patients on hemodialysis. In phase 1, subjects were counseled according to current renal nutrition guidelines. In phase 2, subjects were kinetically modeled and counseled with incorporation of the urea kinetic modeling-derived protein catabolic rate value. Thirteen subjects received a 1-month follow-up. Food records and time length of counseling sessions were recorded in phases 1 and 2. Significant changes seen in the mean blood urea nitrogen value during phase 2 (no. = 22, p less than or equal to .05) and follow-up phase (no. = 13, p less than or equal to 0.05) reflected an improved protein intake from phase 1 for the majority of subjects. Dietary intake and time length of counseling sessions in both phases were not significantly different. The following correlations were noted: reported protein intake and protein catabolic rate: r = .685, p less than or equal to .001; protein catabolic rate and blood urea nitrogen: r = .799, p less than or equal to .001; blood urea nitrogen and serum albumin: r = .485, p less than or equal to .05. Results suggest that the urea kinetic modeling-derived protein catabolic rate value positively affects patient adherence to diet recommendations.(ABSTRACT TRUNCATED AT 250 WORDS)