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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.

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  1. Which of the following dietary interventions has the strongest evidence for slowing CKD progression in non-dialysis CKD patients?

    Answer: Low-protein diet (0.6–0.8 g/kg/day) to reduce hyperfiltration and uremic toxin load

    Low-protein diets (0.6–0.8 g/kg/day) reduce intraglomerular pressure (by decreasing hyperfiltration), lower the uremic toxin load, and decrease proteinuria, collectively slowing CKD progression according to multiple meta-analyses and KDIGO guidelines.

  2. A renal dietitian is using Subjective Global Assessment (SGA) for a dialysis patient. Which component is assessed in SGA?

    Answer: Dietary intake history and physical examination findings

    SGA is a clinical tool that combines dietary history (weight changes, appetite, dietary intake changes, GI symptoms) with physical examination findings (subcutaneous fat, muscle wasting, edema) to categorize nutritional status as A (well-nourished), B (mild-moderate malnutrition), or C (severe malnutrition).

  3. For a non-dialysis CKD Stage 3–5 patient, what is the KDOQI-recommended energy intake to maintain neutral nitrogen balance?

    Answer: 30–35 kcal/kg/day ideal body weight

    KDOQI 2020 recommends 25–35 kcal/kg IBW/day for CKD non-dialysis patients to maintain nitrogen balance and preserve body weight. The range of 30–35 kcal/kg/day is used for most adults; lower end applies to sedentary or overweight patients.

  4. Which biomarker has the LONGEST half-life, making it a marker of chronic (long-term) protein status rather than acute changes?

    Answer: Albumin

    Albumin has a half-life of approximately 17–21 days, making it reflect protein status over weeks. Prealbumin has a half-life of 2–3 days (acute changes) and retinol-binding protein has a half-life of 12 hours (very short-term).

  5. A patient on hemodialysis reports persistent nausea, early satiety, and decreased appetite. Which dialysis-related factor most commonly contributes to these symptoms?

    Answer: Accumulation of uremic toxins due to inadequate dialysis dose (low Kt/V)

    Inadequate dialysis dose (Kt/V < 1.2 per session) results in accumulation of uremic toxins that cause uremic gastroparesis, nausea, anorexia, and early satiety — major contributors to malnutrition in dialysis patients.

  6. Which vitamin is CONTRAINDICATED as a supplement (in standard doses) in CKD patients due to its accumulation causing increased risk of oxalosis and renal stone formation?

    Answer: Vitamin C (ascorbic acid)

    In CKD, supplemental vitamin C (> 60–100 mg/day) should be avoided because impaired renal excretion causes oxalate accumulation (vitamin C is metabolized to oxalate), potentially worsening CKD progression and causing systemic oxalosis.