TABLE OF CONTENTS T-1. A-1 Acronyms and Abbreviations. S-1 Stages of Chronic Kidney Disease (CKD)

Transcription

1 A-1 Acronyms and Abbreviations TABLE OF CONTENTS S-1 Stages of Chronic Kidney Disease (CKD) Chapter 1: Nutrition Assessment Charts, Tables and Formulas 1-2 Practical Steps to Nutrition Assessment Adult Patients 1-3 Nutrition Care Process (NCP) Model 1-4 NCP Overview 1-7 NCP Applications in CKD 1-8 Nutrition Care Process: Nutrition Diagnostic Statements PES 1-9 KDOQI Assessment and Monitoring Recommendations 1-10 Tips for Effective Assessment, Interviewing and Teaching 1-11 Height Estimation From Knee Height 1-12 Height Estimation From Arm Span/Demi-Span 1-13 Height Estimation From Forearm 1-14 Determination of Frame Size by Elbow Breadth 1-15 Determination of Frame Size by Wrist Circumference 1-16 Patient-Determined Frame Size 1-17 Methods to Determine Body Weights for Nutrient Calculations 1-18 Standard Body Weight 1-19 Metropolitan Life Height and Weight Tables for Adults Males 1-20 Metropolitan Life Height and Weight Tables for Adults Females T-1

2 1-21 Weight for Height Tables for Filipinos 1-22 Desirable Body Weight Based on BMI 1-23 Adjusted Body Weight for the Obese or Underweight Patient 1-25 Estimating Dry Weight 1-26 Clinical Signs of Fluid Status in Dialysis Patients 1-26 Usual Fluid Intake and Output in Adults Without Kidney Disease 1-27 Weight Comparison Formulas 1-28 Weight Estimation in Amputees 1-29 Body Mass Index (BMI) 1-30 Body Mass Index Classifications 1-31 Creatinine Index (Estimates Edema-Free Lean Body Mass) 1-32 Sample Calculation of Edema-Free Lean Body Mass (LBM) 1-33 Body Surface Area (BSA) Formulas 1-34 Body Surface Area Nomogram 1-35 Total Body Water Formulas 1-36 Arm Anthropometrics 1-37 Reference Values for the Triceps Skinfold Thickness Male 1-38 Reference Values for the Triceps Skinfold Thickness Female 1-39 Reference Values for Mid-Arm Muscle Circumference 1-40 Reference Values for Mid-Upper Arm Muscle Area Male 1-41 Reference Values for Mid-Upper Arm Muscle Area Female 1-42 Other Measures of Body Composition 1-43 Subjective Global Assessment (SGA) 1-44 Editor s Note on SGA T-2

3 1-45 SGA Weight/Medical/Nutrition History 1-46 Schematic of Muscle to Guide Assessment of Wasting 1-47 SGA Part I 1-48 SGA Part II 1-50 Criteria for Estimation of Performance or Functional Status 1-51 Medical Nutrition Therapy (MNT) 1-53 Common Physical Signs of Malnutrition 1-55 Centers for Medicare and Medicaid Services (CMS) Conditions for Coverage (CfC) Chapter 2: Laboratory Values 2-2 General Information 2-3 Conversion Formulas 2-5 Laboratory Tests 2-20 Possible Non-Dietary Causes of Hyperkalemia in Kidney Disease 2-21 Potential Signs and Symptoms of Abnormal Serum Potassium 2-22 Acidosis/Acidemia 2-23 Acidosis/Alkalosis 2-24 Na + /K + Content of Salt and Salt Substitutes Chapter 3: Medications 3-2 Medications in CKD 3-3 Antihypertensives 3-6 Antidepressants 3-8 Antilipemics/Antihyperlipidemics T-3

4 3-10 Anticonvulsants 3-11 Gout Treatments 3-12 Gout Medications 3-13 Nonsteroidal Anti-Inflammatory Drugs 3-14 Potential Nutrition Effects of Common Immunosuppressant Drugs 3-15 Drug-Nutrient Interactions 3-16 Drugs That May Impair Absorption or Utilization of Nutrients 3-17 Drug Actions on Nutrition 3-18 Herbal Supplements 3-19 Potentially Detrimental Herbal Supplements in CKD 3-21 Potentially Beneficial Herbal Supplements in CKD Chapter 4: Nutrient Prescription 4-2 General lnformation 4-3 Daily Nutrient Recommendations for CKD 4-5 L-Carnitine Supplementation in Hemodialysis Patients 4-6 Nutritional Effects of HIV/AIDS 4-7 Nutrient Recommendations for AIDS and Dialysis 4-8 Harris-Benedict Formulas for Resting Energy Expenditure (REE) 4-9 Suggested Adjustment Factors for Energy Needs During Acute Illness 4-10 Estimated Energy Needs in Spinal Cord Injury Patients 4-11 Estimates of Calories Absorbed Per Liter From Peritoneal Dialysate 4-13 National Renal Diet Food Choice Lists (CKD Not on Dialysis) 4-14 National Renal Diet Food Choice Lists (CKD on Dialysis) T-4

5 4-15 Vitamins Formulated for CKD Patients 4-16 Considerations for a Kosher Diet 4-17 Composition of Common High-Fiber Cereals 4-18 Composition of Milk and Substitutes Chapter 5: Diabetes Mellitus 5-2 Definitions of Diabetes 5-2 Typical Blood Glucose Values 5-3 Common Symptoms and Treatment of Diabetes 5-4 Glycated Hemoglobin (HbA 1c ) 5-5 Correlation Between HbA 1c Level and Mean Plasma Glucose 5-6 Stages of Diabetic Nephropathy 5-8 Screening for Kidney Disease 5-8 Definitions of Albumin Excretion Abnormalities 5-8 Factors That Potentially Influence Microalbuminuria Results 5-9 Recommended Daily Dietary Modification in Diabetic Nephropathy 5-10 Oral Hypoglycemic Agents 5-12 Insulin 5-13 Hypoglycemia in CKD 5-14 Food Glucose Equivalent to 15 gm Carbohydrate 5-15 Modifications for Acute Illness in Insulin-Dependent DM 5-16 Diabetes Management With Intercurrent Issues 5-17 Other Nutrition Issues for Diabetics 5-18 Sugar Alcohol and Non-Nutritive Sweeteners T-5

6 5-19 Diabetic Gastroparesis 5-20 Pancreas Transplant Chapter 6: Malnutrition 6-2 Descriptive Terms Relating to Abnormal Nutrition 6-4 Protein-Energy Wasting (PEW) in Kidney Disease 6-5 PEW 6-6 ISRNM Indicators for PEW 6-7 Diagnosis of PEW 6-7 ISRNM PEW Evaluation of Weight Loss 6-8 Negative Acute-Phase Reactants 6-9 Positive Acute-Phase Reactants 6-10 Indications and Steps for Implementation of Nutrition Support 6-11 Supplemental Enteral Feeding 6-12 Enteral Nutrition Formulas 6-13 Enteral Nutrition Supplements 6-14 Specialty Nutrition Bars/Cookies 6-15 Specialty Nutrition Products 6-16 Modular Products 6-17 Oral Amino Acid Therapy 6-18 Tube Feedings in CKD 6-20 Common Tube Feeding Sites 6-21 Tube Feeding Formulas 6-22 Common Tube Feeding Products T-6

7 6-23 Gastrointestinal Motility Studies 6-24 Intradialytic Parenteral Nutrition (IDPN) 6-25 IDPN Nutrients/Formulas 6-26 Other Considerations for IDPN 6-27 Intraperitoneal Nutrition (IPN)/Intraperitoneal Amino Acids (IPAA) 6-28 Determining the Appropriate IPN Solutions 6-29 Parenteral Nutrition Solution for Acute Kidney Injury (AKI) 6-31 Nutrition Support Monitoring Guidelines in the Stable Dialysis Patient 6-32 Nitrogen Balance Chapter 7: Dyslipidemia, Hypertension and Cardiovascular Disease 7-2 Introduction 7-4 ATP III Guideline Definitions of Dyslipidemia 7-5 National Cholesterol Education Program (NCEP), General Patterns of Dyslipidemia in CKD 7-6 Calculation of LDL Cholesterol (Friedewald Formula) 7-7 Treatment Recommendations for Correction of Dyslipidemias in CKD Stage Therapeutic Lifestyle Changes (TLC) 7-9 Common Food Sources of Fat 7-10 Approximate Cholesterol Content of Common Foods 7-11 Hypertension 7-12 Recommendations for Antihypertensive Therapy in CKD 7-13 Risk Factors for Developing Cardiovascular Complications 7-14 Evaluation and Interventions for CVD T-7

8 Chapter 8: CKD Mineral and Bone Disorder 8-2 Bone and Mineral Metabolism Abnormalities in CKD 8-3 KDIGO Definitions of Mineral and Bone Abnormalities in CKD 8-4 Manifestations of Abnormal Mineral and Bone Metabolism 8-5 Abnormal Mineral and Bone States in CKD 8-6 Suggested Target Ranges for Biochemical Markers of CKD-MBD 8-7 Other CKD-MBD Recommendations 8-8 Phosphorus in CKD Stage 5D 8-9 Phosphorus Density of Common Foods 8-11 Phosphorus Food Additives 8-13 Phosphate Binding and Calcium Supplementation 8-14 Calcium Compounds 8-15 Available Phosphate Binder Compounds 8-17 Vitamin D (OH)D Levels and Recommendations in CKD Stages Defining 25(OH)D Insufficiency/Deficiency (Non CKD) 8-20 General Recommendations for Adequate Intake (AI) of Vitamin D 8-21 Food Sources of Vitamin D 8-22 Calcitriol and Analogs of Calcitriol (U.S.) 8-23 Actions of Pharmacologic Agents Used to Treat SHPT 8-24 Protocols for Management of CKD-MBD 8-25 Initial Dosing for Vitamin D Sterols Per HD Treatment 8-26 Cinacalcet (Sensipar) T-8

9 8-27 Formulas for Adjusted Calcium 8-28 Symptoms of Abnormal Serum Calcium Levels 8-28 Etiology of Hypercalcemia 8-29 Soft Tissue/Vascular Calcification in CKD 8-31 Potential Indications for Parathyroidectomy 8-32 Common Clinical Course After Parathyroidectomy 8-33 Urolithiasis (Nephrolithiasis/Kidney Stones) 8-34 Nutrition Interventions for Kidney Stones 8-36 Oxalate Content of Common Foods Chapter 9: Anemia 9-2 Anemia 9-3 Terminology Used to Describe Cell Alterations in Anemia 9-4 Morphologic Types and Characteristics of Anemia 9-5 Laboratory Values Used to Evaluate Anemia in CKD 9-7 Interpretation of Iron Status Parameters 9-8 Diagnosis of Anemia Requiring Further Evaluation 9-8 Anemia in Transplant CKD 9-9 Therapeutic CKD Anemia Targets for Those on ESA 9-10 Iron Supplementation in CKD Patients 9-11 Iron Supplements (Oral) 9-12 Iron Supplements (IV) 9-13 Factors Most Commonly Associated With Hyporesponse to ESA Therapy T-9

10 Chapter 10: Adequacy of Dialysis 10-2 Kinetic Modeling Glossary 10-7 Methods of Measuring Hemodialysis Adequacy 10-9 Hemodialysis Adequacy Targets Other Clinical Practice Recommendations for HD Adequacy Types of Hemodialysis Components of Kt/V Parameters That Affect HD Adequacy Total Body Water (Volume) Volume From Surface Area (VSA) Formulas Differences Between Single Pool and Double Pool Kinetics Estimates of Protein Intake From Urea Kinetics Estimates of PCRn (npcr) Using Formulas That Employ Kt/V Other Adequacy Parameters Common Causes of Delivered Kt/V Unequal to Prescribed Kt/V HelpfuI Information for Analysis of UKM Results Steps to Error Analysis of Formal HD UKM Error Analysis for Formal UKM Formulas for Other Measures of HD Adequacy Formulas to Estimate Equilibrated Kt/V (ekt/v) Daily Hemodialysis Dialysis Dose With NxStage Technology Peritoneal Dialysis T-10

11 10-31 Peritoneal Dialysis Adequacy Targets Aspects of Peritoneal Dialysis Adequacy Achieving Peritoneal Dialysis Adequacy Targets PD Adequacy Calculations Kt/V PD Adequacy Calculations PNA Summary of KDOQI PD Adequacy Guidelines Urea Kinetics for CKD Not on Dialysis Nutrition Intervention Based on npna Glomerular Filtration Rate (GFR) Calculations Chapter 11: Special Populations With CKD (Pediatrics, Pregnancy, Older Adults, Transplant) 11-2 Evaluation of Nutritional Status in Pediatric CKD Patients 11-3 Reference Table Resources 11-4 Indications for Nutrition Intervention 11-5 Energy Needs for Children With CKD Stages 2-5 and 5D 11-6 Macronutrient Ranges for Children With CKD Stages 2-5 and 5D 11-7 Protein Recommendations for Children With CKD Stages 3-5 and 5D 11-8 Vitamins and Trace Elements for Children With CKD Stages 2-5 and 5D 11-8 Elemental Calcium Recommendations for Children With CKD 11-9 Phosphorus Recommendations for Children With CKD Stages 3-5 and 5D 11-9 Higher Than Normal Values for Serum P Based on Age Correcting Growth and Metabolic Deficits in Children With CKD Stages 2-5 and 5D Calculation of npcr in Adolescents With CKD Stage 5HD Recommendations for the Pregnant Patient With CKD T-11

12 11-14 Other Recommendations for the Pregnant HD Patient Special Issues for the Older Adult CKD Patient Potential Influences on Nutritional Status in the Older Adult Dialysis in the Older Adult Limitations of Common Nutrition Assessment Parameters in Older Adult CKD Patients Education Considerations for Older Adults Special Issues for the Kidney Transplant Patient Nutrient Recommendations for the Kidney Transplant Patient N-1 Notes T-12