Nutrition management in hemodialysis

Nutritional management is a significant part of care for patients undergoing hemodialysis treatment. The main goals are to optimize nutritional status, including prevention and treatment of protein-energy wasting (PEW), correction of nutrient deficiency, and management of electrolyte and fluid balance. This chapter will address the range of factors that affect nutritional status in end-stage kidney disease, including the prevalence, methods of assessment, and management of the following issues: PEW, electrolyte disturbance, fluid balance, and vitamin and mineral deficiencies. Optimizing nutritional status requires attention to risk factors, including frequent screening and dedicated management of nutritional issues, preferably overseen by an appropriately credentialed dietitian, specially trained to manage the unique and complex array of requirements of hemodialysis patients.