Question

How does the medical nutrition therapy for short-term versus long-term

renal disease differ?

Answer 1

Ans) AKI: Medical Nutrition therapy

Caloric needs: spare protein

Estimate 20-35 kcals/kg/d dry wt (or IBW)

Avoid overfeeding excess CO2 prodn

use of commercial renal formulas low in protein and electrolytes helpful; added vegetable oils, margarines, sugar to boost kcals.

CKI Medical Nutrition therapy:

Nutritional management in stages 1-4 CKD:

- A reduction in waste excretion, fluid and electrolyte balance and decreased calcitriol and eythropoeitin production leads to azotemia, edema, secondary hyperparathyroidism, anemia, HTN and dyslipidemia in CKD.

Symptoms of uremia - malaise, weakness, nausea/vomiting, etc lead to a decreased quality of life for patients and eventually, as GFR decreases to <15, renal replacement therapy (RRT) or transplant is needed.

Protein restriction 0.6 g/kg/d - 0.75g/kg/d (NKF), 0.8 g/kg/d (ADA)
Nephrotic Syndrome - meet needs for protein losses
0.8-1.0 g/kg/d
Energy - meet caloric needs 30-35 kcals/kg/d to spare protein.
Carbohydrates - meet caloric needs; maintain optimal blood glucose (HbA1c goals vary depending on patient age and comorbidities