CSR CSR Dialysis Nutrition & Renal Replacement Therapy 1 — Questions and Answers
Question 1: What is the recommended daily protein intake for a stable adult hemodialysis patient per KDOQI guidelines?
- 0.6–0.8 g/kg/day
- 0.8–1.0 g/kg/day
- 1.2–1.4 g/kg/day (Correct answer)
- 1.5–2.0 g/kg/day
Correct answer: 1.2–1.4 g/kg/day
Hemodialysis patients require 1.2–1.4 g/kg/day of protein to compensate for dialysis-related catabolism and amino acid losses.
Question 2: Which dialysis modality results in greater continuous protein and amino acid losses due to membrane permeability?
- Conventional hemodialysis (3×/week)
- Peritoneal dialysis (Correct answer)
- High-flux hemodialysis
- Intermittent hemodiafiltration
Correct answer: Peritoneal dialysis
Peritoneal dialysis results in significant ongoing protein and amino acid losses through the peritoneal membrane with each exchange.
Question 3: Intradialytic parenteral nutrition (IDPN) is clinically indicated for hemodialysis patients who have which condition?
- Hyperphosphatemia unresponsive to binders
- Inadequate oral/enteral intake despite dietary counseling (Correct answer)
- Hyperkalemia requiring dietary restriction
- Fluid overload between sessions
Correct answer: Inadequate oral/enteral intake despite dietary counseling
IDPN supplements nutrition delivered during hemodialysis sessions when oral and enteral intake are insufficient.
Question 4: What is the typical recommended dietary phosphorus range for dialysis patients to prevent hyperphosphatemia?
- Less than 500 mg/day
- 800–1000 mg/day (Correct answer)
- 1200–1500 mg/day
- No restriction needed
Correct answer: 800–1000 mg/day
Dialysis patients are generally advised to restrict phosphorus to 800–1000 mg/day to control serum phosphorus levels.
Question 5: Which hemodialysis frequency allows the greatest dietary fluid liberalization due to more frequent fluid removal?
- Conventional hemodialysis (3×/week)
- Daily hemodialysis (6×/week) (Correct answer)
- Peritoneal dialysis (4 exchanges/day)
- CRRT in ICU setting
Correct answer: Daily hemodialysis (6×/week)
Daily hemodialysis allows more fluid removal sessions per week, enabling a more liberal daily fluid intake allowance.
Question 6: In dialysis patients, 'dry weight' is best defined as:
- Body weight after a 24-hour fast
- The estimated post-dialysis weight representing euvolemia without excess fluid (Correct answer)
- Weight measured in the morning before eating
- Post-exercise weight after fluid losses
Correct answer: The estimated post-dialysis weight representing euvolemia without excess fluid
Dry weight is the target post-dialysis weight representing the patient's optimal fluid-balanced (euvolemic) state.
CSR CSR Dialysis Nutrition & Renal Replacement Therapy 1
What is the recommended daily protein intake for a stable adult hemodialysis patient per KDOQI guidelines?