777-Renal Nutrition UPDATED ACTUAL
Questions and CORRECT Answers
Functions of normal kidney - CORRECT ANSWER - o Filter waste products
o Maintain fluid balance
o Regulate electrolyte status
o Role in blood pressure regulation
o Stimulation of red blood cell production
o Maintain bone health, regulation of calcium and phosphorus metabolism by activation of
Vitamin D and excretion of excess phosphorus
Characterized by decrease in removal of waste products. As disease progresses, rises in urea
blood level can cause nausea, fatigue, loss of appetite. Urine output may begin to decline. -
CORRECT ANSWER - Renal Insufficiency or CKD Stages 1-4
Deterioration of renal function to a level at which uremia can cause death unless treatment is
initiated to replace renal function. - CORRECT ANSWER - End Stage Renal Disease or
CKD Stage 5
at risk of CKD - CORRECT ANSWER - DM, HTN, family hx, age, ethnicity
GFR: >90
stage 1 - CORRECT ANSWER - Kidney damage (protein in urine)
GFR >90
stage 2 - CORRECT ANSWER - Kidney damage + decrease in GFR
GFR 60-89
,stage 3 - CORRECT ANSWER - Moderate decrease in GFR
GFR 30-59
stage 4 - CORRECT ANSWER - Severe decrease in GFR
GFR 15-29
stage 5 - CORRECT ANSWER - Kidney failure (dialysis or tx needed)
GFR <15
Medical Nutrition Therapy Goals in Kidney Disease - CORRECT ANSWER -•
Prevention/treatment of malnutrition, weight maintenance, decreased morbidity and mortality
• Control and correct an overload of products of protein metabolism
• Maintain resistance to infection, control tissue catabolism
• Maintain electrolyte balance
• Maintain fluid balance
• Prevent/control renal bone disease by maintaining calcium and phosphorus balance.
Despite advances in dialysis techniques, the mortality rate for those on maintenance dialysis
remains ____ per year. - CORRECT ANSWER - ~ 20%
Epidemiological studies repeatedly and consistently show a strong association b/t what? -
CORRECT ANSWER - clinical outcome and measures of malnutrition and inflammation
, Reported prevalence of PEW (protein energy wasting) varies greatly b/t _______ in dialysis
patients according to type of dialysis, nutritional assessment tools, and origin of pt population. -
CORRECT ANSWER - 45%-75%
2/3 of all maintenance dialysis pts in the US exhibit ______ - CORRECT ANSWER -
hypoaluminemia
causes of malnutrition in kidney disease - CORRECT ANSWER - o Decreased nutrient
intake
o Abnormal renal metabolism
o Abnormal mineral metabolism
o Losses of nutrients into dialysate
o Metabolic acidosis
o Hypercatabolism due to dialysis
o Frequent concurrent illnesses
The National Kidney Foundation has developed clinical guidelines ... what are those called -
CORRECT ANSWER - NKF-KDOQI Guidelines
steps of KDOQI guidelines - CORRECT ANSWER - 1. Evaluation of protein-energy
nutritional status
2. Management of protein and energy intake (very individualized)
3. Intensive nutritional counseling of individuals with CKD.
a valid and clinically useful measure of protein-energy nutritional status in maintenance dialysis
patients - CORRECT ANSWER - -serum pre-albumin
-Serum Albumin
-serum cholesterol
-serum creatinine and the creatinine index
Questions and CORRECT Answers
Functions of normal kidney - CORRECT ANSWER - o Filter waste products
o Maintain fluid balance
o Regulate electrolyte status
o Role in blood pressure regulation
o Stimulation of red blood cell production
o Maintain bone health, regulation of calcium and phosphorus metabolism by activation of
Vitamin D and excretion of excess phosphorus
Characterized by decrease in removal of waste products. As disease progresses, rises in urea
blood level can cause nausea, fatigue, loss of appetite. Urine output may begin to decline. -
CORRECT ANSWER - Renal Insufficiency or CKD Stages 1-4
Deterioration of renal function to a level at which uremia can cause death unless treatment is
initiated to replace renal function. - CORRECT ANSWER - End Stage Renal Disease or
CKD Stage 5
at risk of CKD - CORRECT ANSWER - DM, HTN, family hx, age, ethnicity
GFR: >90
stage 1 - CORRECT ANSWER - Kidney damage (protein in urine)
GFR >90
stage 2 - CORRECT ANSWER - Kidney damage + decrease in GFR
GFR 60-89
,stage 3 - CORRECT ANSWER - Moderate decrease in GFR
GFR 30-59
stage 4 - CORRECT ANSWER - Severe decrease in GFR
GFR 15-29
stage 5 - CORRECT ANSWER - Kidney failure (dialysis or tx needed)
GFR <15
Medical Nutrition Therapy Goals in Kidney Disease - CORRECT ANSWER -•
Prevention/treatment of malnutrition, weight maintenance, decreased morbidity and mortality
• Control and correct an overload of products of protein metabolism
• Maintain resistance to infection, control tissue catabolism
• Maintain electrolyte balance
• Maintain fluid balance
• Prevent/control renal bone disease by maintaining calcium and phosphorus balance.
Despite advances in dialysis techniques, the mortality rate for those on maintenance dialysis
remains ____ per year. - CORRECT ANSWER - ~ 20%
Epidemiological studies repeatedly and consistently show a strong association b/t what? -
CORRECT ANSWER - clinical outcome and measures of malnutrition and inflammation
, Reported prevalence of PEW (protein energy wasting) varies greatly b/t _______ in dialysis
patients according to type of dialysis, nutritional assessment tools, and origin of pt population. -
CORRECT ANSWER - 45%-75%
2/3 of all maintenance dialysis pts in the US exhibit ______ - CORRECT ANSWER -
hypoaluminemia
causes of malnutrition in kidney disease - CORRECT ANSWER - o Decreased nutrient
intake
o Abnormal renal metabolism
o Abnormal mineral metabolism
o Losses of nutrients into dialysate
o Metabolic acidosis
o Hypercatabolism due to dialysis
o Frequent concurrent illnesses
The National Kidney Foundation has developed clinical guidelines ... what are those called -
CORRECT ANSWER - NKF-KDOQI Guidelines
steps of KDOQI guidelines - CORRECT ANSWER - 1. Evaluation of protein-energy
nutritional status
2. Management of protein and energy intake (very individualized)
3. Intensive nutritional counseling of individuals with CKD.
a valid and clinically useful measure of protein-energy nutritional status in maintenance dialysis
patients - CORRECT ANSWER - -serum pre-albumin
-Serum Albumin
-serum cholesterol
-serum creatinine and the creatinine index
