Nutrition Assessment & Intervention in Kidney Disease Flashcards
6 cards from real CSR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Nutrition Assessment & Intervention in Kidney Disease flashcards as text
Which anthropometric measurement is MOST useful for assessing nutritional status in a dialysis patient with significant fluid overload?
Answer: Mid-arm muscle circumference (MAMC)
In dialysis patients, body weight and BMI are confounded by fluid status. Mid-arm muscle circumference (MAMC), derived from mid-arm circumference and triceps skinfold, reflects somatic protein stores independent of fluid balance.
A hemodialysis patient has a serum prealbumin of 18 mg/dL. How should this result be interpreted?
Answer: Mildly decreased; warrants monitoring but not immediate intervention
Normal prealbumin in dialysis patients is ≥ 30 mg/dL. Values of 16–30 mg/dL indicate mild-to-moderate depletion requiring monitoring and dietary counseling. Values < 16 mg/dL indicate severe protein-energy wasting.
When calculating protein requirements for a peritoneal dialysis (PD) patient, which additional protein loss must be accounted for compared to hemodialysis patients?
Answer: Protein losses into peritoneal dialysate effluent
In PD, albumin and other proteins are continuously lost into the dialysate at approximately 5–15 g/day for CAPD patients. KDOQI recommends ≥ 1.2–1.3 g/kg/day protein for PD patients to account for these dialysate losses.
Which validated tool is specifically designed and recommended for screening malnutrition risk in patients with chronic kidney disease?
Answer: Malnutrition-Inflammation Score (MIS)
The Malnutrition-Inflammation Score (MIS) is a validated 10-component tool specifically developed for dialysis patients. It incorporates medical history, physical examination (SGA-based), BMI, and laboratory values (albumin, TIBC) to comprehensively assess nutritional-inflammatory status.
A Stage 4 CKD patient (GFR 20 mL/min) weighs 80 kg with an ideal body weight of 70 kg. What is the appropriate basis for calculating dietary protein intake?
Answer: Ideal body weight (70 kg)
KDOQI and KDIGO recommend using ideal body weight (or adjusted body weight in obese patients) for nutrient calculations in CKD patients to avoid overestimating requirements in overweight/obese individuals.
In CKD nutrition assessment, 'protein-energy wasting' (PEW) is defined by the ISRNM as requiring criteria from how many of the four diagnostic categories?
Answer: At least three of the four categories
The International Society of Renal Nutrition and Metabolism (ISRNM) defines PEW when criteria from at least 3 of the 4 categories are met: biochemical criteria, low body weight/BMI/fat mass, reduced muscle mass, and low dietary protein or energy intake.