CDN Renal & Cardiac Nutrition 2 — Questions and Answers
Question 1: A patient on hemodialysis has a serum phosphorus of 7.2 mg/dL. Which dietary strategy should be prioritized first?
- Increase calcium intake
- Restrict dietary phosphorus to 800-1000 mg/day (Correct answer)
- Increase dialysis frequency immediately
- Reduce fluid intake
Correct answer: Restrict dietary phosphorus to 800-1000 mg/day
Dietary phosphorus restriction to 800-1000 mg/day is the first-line intervention for hyperphosphatemia in dialysis patients.
Question 2: Which lipoprotein pattern is most commonly associated with increased cardiovascular risk in patients with chronic kidney disease?
- Elevated HDL and low LDL
- Low triglycerides and high LDL
- Elevated triglycerides and low HDL (Correct answer)
- High LDL with normal triglycerides
Correct answer: Elevated triglycerides and low HDL
CKD patients typically exhibit a dyslipidemia pattern of elevated triglycerides and low HDL, increasing cardiovascular risk.
Question 3: A CKD stage 3 patient (GFR 35 mL/min) asks about protein intake. What is the recommended protein level?
- 0.6-0.8 g/kg/day (Correct answer)
- 1.0-1.2 g/kg/day
- 1.5-2.0 g/kg/day
- 2.0-2.5 g/kg/day
Correct answer: 0.6-0.8 g/kg/day
NKF-KDOQI recommends 0.6-0.8 g/kg/day of protein for non-dialysis CKD patients to slow progression.
Question 4: Which cardiac condition most directly requires limiting dietary saturated fat to less than 7% of total calories?
- Atrial fibrillation
- Heart failure with reduced ejection fraction
- Hypercholesterolemia with coronary artery disease (Correct answer)
- Hypertensive heart disease
Correct answer: Hypercholesterolemia with coronary artery disease
Therapeutic lifestyle changes for hypercholesterolemia with CAD include restricting saturated fat to <7% of calories to reduce LDL.
Question 5: A dialysis patient reports muscle cramps during sessions. Laboratory values show serum sodium 138, potassium 4.8, and BUN 65. What is the most likely nutritional cause?
- Hyperkalemia
- Excessive interdialytic weight gain from fluid and sodium intake (Correct answer)
- Low protein intake
- Hyperphosphatemia
Correct answer: Excessive interdialytic weight gain from fluid and sodium intake
Excessive interdialytic fluid and sodium intake leads to large volume shifts during dialysis, causing cramps.
Question 6: Which vitamin supplementation is specifically recommended for hemodialysis patients due to dialysis-related losses?
- Fat-soluble vitamins A, D, E, K
- Water-soluble B vitamins and vitamin C (Correct answer)
- Vitamin A and beta-carotene
- Vitamins D and K only
Correct answer: Water-soluble B vitamins and vitamin C
Hemodialysis removes water-soluble vitamins (B-complex and C) necessitating supplementation with renal-specific formulas.
Question 7: In the DASH diet for hypertension, what is the recommended daily sodium target?
- 3,500 mg
- 2,300 mg or lower (Correct answer)
- 4,000 mg
- 1,000 mg
Correct answer: 2,300 mg or lower
The DASH diet targets ≤2,300 mg sodium/day, with further reduction to 1,500 mg for greater blood pressure lowering.
CDN Renal & Cardiac Nutrition 2
A patient on hemodialysis has a serum phosphorus of 7.2 mg/dL.
Which dietary strategy should be prioritized first?