Nährstoff Täglicher Bedarf
  Info Vorzeichen Bedarf min. Bedarf max. Einheit
Protein Hemodialysis 1.1 1.4

g/d 5
  Peritoneal Dialysis 1.2 1.5

g/d 5
  Peritonitis > 1.5

g/d 10
 
Energie <60 years 35

kcal/d 1
  ≥60 years 30

kcal/d 1
 
 
Flüssigkeit Hemodialysis Urine volume + 1000

mL 2
  Peritoneal Dialysis Urine volume + ultrafiltration + 500

mL 2
 
 
Infotext

Vitamins, Minerals, and Trace Elements

  • Sodium *
    • Requirement: 1.8 - 2.5 g/day (78 – 108 mmol/day) / NaCl: 4.6 – 6.4 g/day (78 – 108 mmol/day) 5
  • Phosphate **
    • Target Serum Level: <1.5 mmol/L 4
    • Requirement: 800 – 1000 mg/day (25 – 32 mmol/day) 5
  • Potassium ***
    • Target Serum Level: 3.5–5.0 mmol/L 4
    • Requirement: 2000 - 2500 mg/day (50 – 65 mmol/day) 5
  • Vitamins: Based on dialysis-related losses
    • Vitamin D: Adjusted based on serum calcium, phosphorus, and parathyroid hormone levels

Energy intake and losses in the form of citrate, lactate, and glucose during dialysis or hemofiltration must be accounted for 9.

* Sodium Balance: Sodium and intravascular volume balance is generally maintained by homeostatic mechanisms until eGFR falls below 10 to 15 mL/min/1.73 m². However, patients with mild to moderate CKD have reduced responsiveness to high sodium intake despite relative volume stability, making them prone to fluid overload. Sodium intake should therefore be limited to a maximum of 2.5 g/day (6.4 g NaCl), unless contraindicated, such as in cases of salt-wasting nephropathy.

** Phosphate Balance: Excess phosphate is excreted to maintain a fasting serum concentration of <1.5 mmol/L (4.6 mg/dL) under normal kidney function 12. As eGFR falls below 40 ml/min/1.73 m², the risk of hyperphosphatemia increases, potentially leading to a cascade of negative effects 11. Common complications include disturbances in mineral and bone metabolism, increased vascular calcification, osteoporosis, atherosclerosis 13, and a higher risk of CKD progression and mortality 14. Restricting oral phosphate intake to 600 – 1000 mg (19 – 32 mmol) per day or reducing absorption via phosphate binders is generally indicated when fasting serum levels are ≥1.5 mmol/L 11.

*** Potassium Excretion: About 90% of daily potassium intake is excreted in the urine under normal kidney function. As kidney function declines, particularly with eGFR below 15 mL/min/1.73 m², the risk of hyperkalemia increases, heightening the risk of hypertension, ventricular arrhythmias, and sudden death 15. Treatment involves avoiding hyperkalemia-inducing medications and potassium-rich foods.