If a PD patient has not demonstrated stable protein status with 1.2 g/kg/day, what should be used?

• A. 1.0 g/kg/day
• B. 1.2 g/kg/day
• C. 1.3 g/kg/day
• D. 1.5 g/kg/day

Answer: (C)

In peritoneal dialysis, protein is continually lost into the dialysate, so the daily protein target is higher than for those not on PD. The typical range is about 1.2 to 1.3 g/kg/day to support nitrogen balance and maintain serum proteins like albumin. If stability isn’t achieved at 1.2 g/kg/day, the best next step is to raise the target to 1.3 g/kg/day. This modest increase addresses ongoing losses without jumping to a much higher intake unless there are signs of persistent malnutrition or inflammation. Lowering to 1.0 g/kg/day would worsen protein status, and sticking at 1.2 g/kg/day when stability isn’t achieved wouldn’t resolve the issue; a small upward adjustment to 1.3 g/kg/day is the appropriate next move.