CSR Nutrition Assessment & Intervention in Kidney Disease 2

Question 1

Which anthropometric measurement is MOST useful for assessing nutritional status in a dialysis patient with significant fluid overload?

Accepted Answer

Mid-arm muscle circumference (MAMC)

Answer

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.

Question 2

A hemodialysis patient has a serum prealbumin of 18 mg/dL. How should this result be interpreted?

Accepted Answer

Mildly decreased; warrants monitoring but not immediate intervention

Answer

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.

Question 3

When calculating protein requirements for a peritoneal dialysis (PD) patient, which additional protein loss must be accounted for compared to hemodialysis patients?

Accepted Answer

Protein losses into peritoneal dialysate effluent

Answer

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.

Question 4

Which validated tool is specifically designed and recommended for screening malnutrition risk in patients with chronic kidney disease?

Accepted Answer

Malnutrition-Inflammation Score (MIS)

Answer

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.

Question 5

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?

Accepted Answer

Ideal body weight (70 kg)

Answer

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.

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

CSR Nutrition Assessment & Intervention in Kidney Disease 2