What is the recommended daily energy intake (kcal/kg) for patients over 60 receiving dialysis?

• A. 25 kcal/kg
• B. 40 kcal/kg
• C. 35 kcal/kg
• D. 30-35 kcal/kg

Answer: (D)

The main point is that energy needs for patients over 60 receiving dialysis are set with a range to accommodate individual differences while ensuring adequate lean tissue and overall nutrition. For older adults on dialysis, a daily target of about 30-35 kcal per kilogram of body weight is recommended, typically presented as a range. This range reflects the variability in body size, activity level, edema, and the catabolic stress of dialysis, helping to prevent both malnutrition and excess fat gain.

Choosing a single value outside that range is less adaptable to individual circumstances: 25 kcal/kg is usually too low for this group and risks undernutrition, while 40 kcal/kg is higher than necessary and can lead to unwanted weight gain. The upper end of the range, 35 kcal/kg, is appropriate for some patients but does not capture the need for a flexible target across all individuals. Therefore, 30-35 kcal/kg/day best represents the typical recommendation for this population.