Nutritional implications of renal disease. II. The dietitian's key role in studies of dialysis therapy.

As research develops better dialysis techniques, the dietitian's input in the management of patients with renal disease is vital, for their protein status must be "fine tuned" with individualized treatment and counseling. Her pivotal role is being demonstrated in the National Cooperative Dialysis Study of the National Institutes of Health, one phase of which is being conducted by three hospitals in San Francisco. In that study, close monitoring of the protein catabolic rate (PCR) and blood urea nitrogen (BUN) in predialysis patients, coupled with adjustments in therapeutic dietary regimens and counseling as indicated, shows promise of bringing such patients into good control, targeted at 80+/-10 per cent bun with a PCR of 1.1+/-0.3 gm. per kilogram per 24 hr. Various dietary techniques, either singly or in combination, are being employed in an attempt to control dietary intake.