CSR Protein and Energy Requirements for Dialysis Patients

Question 1

A stable patient on peritoneal dialysis weighs 65 kg (IBW 62 kg). According to KDOQI 2020, what is the minimum daily protein intake recommendation?

Accepted Answer

1.2–1.3 g/kg IBW/day = 74–81 g/day

Answer

0.6 g/kg/day = 37 g/day

Answer

0.8 g/kg/day = 50 g/day

Answer

1.5–2.0 g/kg/day = 93–124 g/day

Question 2

Which amino acid is classified as 'conditionally essential' and particularly important to supplement in dialysis patients due to its accelerated utilization and depletion?

Accepted Answer

Glutamine

Answer

Carnitine

Answer

Glycine

Answer

Serine

Question 3

What is the recommended minimum energy intake for a hospitalized hemodialysis patient with an acute infection (higher catabolism)?

Accepted Answer

30–35 kcal/kg IBW/day, potentially increasing to 35–40 kcal/kg during acute illness

Answer

20–25 kcal/kg/day

Answer

15–20 kcal/kg/day to reduce metabolic burden

Answer

50–60 kcal/kg/day to overcome catabolism

Question 4

A hemodialysis patient has a body weight of 75 kg but has significant edema (+5 kg estimated). What should the dietitian use to calculate protein and energy requirements?

Accepted Answer

Estimated dry weight (approximately 70 kg after removing estimated edema) or IBW, whichever is appropriate

Answer

Actual body weight 75 kg (including edema)

Answer

Ideal body weight from height-weight tables regardless of actual size

Answer

Do not calculate requirements until edema is resolved

Question 5

Intradialytic parenteral nutrition (IDPN) is sometimes used to supplement nutrition in HD patients. What is the PRIMARY indication for IDPN?

Accepted Answer

IDPN is indicated when oral intake is inadequate and oral nutritional supplements have failed to achieve targets, particularly in patients with moderate-to-severe protein-energy wasting who cannot tolerate enteral nutrition

Answer

IDPN is first-line treatment for all malnourished HD patients

Answer

IDPN replaces all oral nutrition for HD patients with PEW

Answer

IDPN is indicated only for patients with serum albumin < 2.0 g/dL

Question 6

Which protein quality scoring system is currently considered the GOLD STANDARD for evaluating protein quality and its applicability to renal nutrition counseling?

Accepted Answer

Digestible Indispensable Amino Acid Score (DIAAS)

Answer

Protein Efficiency Ratio (PER)

Answer

Biological Value (BV)

Answer

Net Protein Utilization (NPU)