CSR Risk Assessment & Mitigation 2

Question 1

A patient with CKD stage 4 has a serum phosphorus of 6.8 mg/dL and is prescribed a calcium-based phosphate binder. What is the primary risk the renal dietitian should monitor for in this scenario?

Accepted Answer

Vascular and soft tissue calcification

Answer

Calcium-based phosphate binders increase the calcium load and, when combined with elevated phosphorus, promote vascular and soft tissue calcification, increasing cardiovascular mortality risk.

Question 2

Which tool is most appropriate for screening malnutrition risk in a hospitalized ESRD patient prior to a dietitian's full nutritional assessment?

Accepted Answer

Malnutrition Universal Screening Tool (MUST)

Answer

MUST is validated for rapid inpatient malnutrition risk screening and helps triage which patients require a more comprehensive assessment.

Question 3

A hemodialysis patient's normalized protein catabolic rate (nPCR) drops from 1.1 to 0.7 g/kg/day over 3 months. What nutritional risk does this trend indicate?

Accepted Answer

Protein-energy wasting and inadequate dietary intake

Answer

A declining nPCR below 1.0 g/kg/day in hemodialysis patients signals inadequate protein intake and is a marker of protein-energy wasting risk.

Question 4

Which serum marker, when persistently low, is the strongest independent predictor of mortality risk in dialysis patients according to current evidence?

Accepted Answer

Serum albumin

Answer

Serum albumin below 3.5 g/dL is consistently associated with significantly increased all-cause and cardiovascular mortality in dialysis patients, despite its role as an inflammation marker.

Question 5

A peritoneal dialysis patient gains 4 kg over 2 months without a dietary change. Which risk should the dietitian prioritize investigating?

Accepted Answer

Glucose absorption from peritoneal dialysate

Answer

PD patients absorb significant glucose from dialysate, which can lead to hypertriglyceridemia, obesity, and metabolic complications that must be assessed and mitigated.

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

CSR Risk Assessment & Mitigation 2