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MESSAGE
Year : 2018  |  Volume : 3  |  Issue : 1  |  Page : 4

Message


Secretary SRNM Organizing Secretary Advance Course In Renal Nutrition And Metabolism And Workshop CKD On Nutritional Screening And Assessment

Date of Web Publication16-May-2018

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2395-1540.232546

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How to cite this article:
Saxena A. Message. J Renal Nutr Metab 2018;3:4

How to cite this URL:
Saxena A. Message. J Renal Nutr Metab [serial online] 2018 [cited 2018 Nov 17];3:4. Available from: http://www.jrnm.in/text.asp?2018/3/1/4/232546


Chronic kidney disease (CKD) is a major contributor to the global burden of non-communicable diseases. Three Principal Outcomes of CKD are progressive loss of renal function, development and progression of cardiovascular disease and development of malnutrition (protein–energy wasting). In CKD Protein-energy-wasting” (PEW) is multifactorial. It is precipitated by reduced dietary intake caused by uremic syndrome which involves complex interplay of inflammation, infection, co-morbidities, anemia, metabolic acidosis, hormonal imbalance including decreased insulin sensitivity, insulin resistance, IGF-I axis, abnormal PTH level, aldosterone, imbalance in orexigenic and anorexogenic hormones and in dialysis dependent patients, the dialysis procedure itself which causes loss of nutrients (vitamins, peptides and aminoacids) and other associated disorders which affects quality of life and survival. The three most widely studied interventions (modifiable characteristics) in their effects on preventing decline in renal function (GFR) are lowering blood pressure, reduction proteinuria, anti-hypertensive drugs. Role of other factors in slowing the progression of CKD are strict glycemic control hyperglycemia, lipid-lowering therapy for dyslipidemia, smoking cessation, dietary modification - protein and salt restriction, regular exercise and weight loss. However, for diagnosing PEW, the first step: is nutrition screening followed by nutrition assessment. Nutritional screening is a process of identifying patients at risk of malnutrition so that more extensive nutrition assessment can be performed. It is a simple and rapid process.and addresses three or four basic questions- like recent weight loss, current body mass index, disease severity and recent food intake. Nutritional assessment is a detailed diagnostic process which characterizes the degree of malnutrition, the risk of medical complications related to malnutrition and the need for nutritional support. It is used to monitor the course of nutritional therapy.

The Nutrition Care Process and Model (NCPM) provides registered dietitian nutritionists (RDNs) and dietetic technicians, registered a framework to recognize, diagnose, and intervene upon nutrition-related health concerns [Figure 1].
Figure 1: Algorithm of Practicing Health Assessment and Diagnostic Accuracy

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Within the NCPM, nutrition assessment is essential to develop a comprehensive evaluation of the client's nutrition. The workshop on Nutritional Screening And Assessment is directed towards training nephrologists, physicians and dieticians in Nutrition Care Process Model (NCP) specific for patients with Chronic Kidney Disease (CKD). This is for the first time that this workshop is being organized in India. The workshop will focus on dietary assessment methods, dietary patterns in hemodialysis patients (dietary monotony; vegetarianism), hands on activity on subjective assessment tools, frailty and functional status assessment, restless leg syndrome, anthropometric measurements: limited ISAK profiling, bioelectrical impedence analysis (BIA), statistical design for dietary analysis which will be followed by and panel discussion on handling patients, observations on meal consumption during dialysis and patient behaviors.

I hope this workshop will be of great utility to the delegates and will help improvise their professional skills. [1]

 
  References Top

1.
Kamimura MA, Draibe SA, Dalboni MA, Cendoroglo M, Avesani CM, Manfredi SR et al. Serum and cellular interleukin-6 in haemodialysis patients: relationship with energy expenditure. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association – European Renal Association 2007; 22(3): 839-44.  Back to cited text no. 1
    


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