CSR CSR Dialysis Nutrition & Renal Replacement Therapy 2 — Questions and Answers
Question 1: In dialysis patients, serum albumin is primarily used as a combined marker of which two clinical conditions?
- Hydration status and phosphorus control
- Dialysis adequacy and residual renal function
- Nutritional status and systemic inflammation (Correct answer)
- Calcium balance and bone health
Correct answer: Nutritional status and systemic inflammation
Serum albumin reflects both nutritional status and inflammatory state, as it is a negative acute-phase reactant in dialysis patients.
Question 2: Kt/V is a clinical measure used to assess which aspect of hemodialysis treatment?
- Dietary protein adequacy
- Dialysis adequacy via urea clearance (Correct answer)
- Volume of ultrafiltration achieved
- Phosphorus removal efficiency
Correct answer: Dialysis adequacy via urea clearance
Kt/V quantifies dialysis adequacy by measuring urea clearance (K×t) relative to body water volume (V).
Question 3: Which vitamin class must be routinely supplemented in dialysis patients because it is removed during treatment sessions?
- Fat-soluble vitamins (A, D, E, K)
- Water-soluble B vitamins (Correct answer)
- Vitamin D analogs only
- Vitamin A and beta-carotene
Correct answer: Water-soluble B vitamins
Water-soluble B vitamins are removed during dialysis and must be replaced through daily supplementation.
Question 4: In peritoneal dialysis patients, which component of the dialysate is absorbed and contributes significantly to caloric intake?
- Albumin in replacement fluid
- Dextrose used as osmotic agent (Correct answer)
- Potassium added to dialysate
- Sodium bicarbonate buffer
Correct answer: Dextrose used as osmotic agent
Dextrose in peritoneal dialysate is absorbed across the peritoneal membrane, contributing meaningful daily caloric load.
Question 5: Normalized protein catabolic rate (nPCR) in hemodialysis patients is used to estimate which nutritional parameter?
- Residual renal function
- Daily dietary protein intake (Correct answer)
- Dialysis membrane efficiency
- Phosphorus removal rate
Correct answer: Daily dietary protein intake
nPCR estimates daily protein intake by calculating the urea generation rate from interdialytic urea accumulation.
Question 6: Malnutrition-inflammation complex syndrome (MICS) in dialysis patients is characterized by which combination of findings?
- High albumin and low C-reactive protein
- Low albumin, elevated CRP, and progressive muscle wasting (Correct answer)
- Elevated phosphorus and suppressed PTH
- Fluid overload and hypernatremia
Correct answer: Low albumin, elevated CRP, and progressive muscle wasting
MICS involves concurrent protein-energy malnutrition and chronic inflammation, reflected by low albumin, elevated CRP, and muscle loss.
CSR CSR Dialysis Nutrition & Renal Replacement Therapy 2
In dialysis patients, serum albumin is primarily used as a combined marker of which two clinical conditions?