Journal of Renal Nutrition and Metabolism

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This article discusses the importance of nutrition intervention and management in clinical dietetic practice with the aid of nutrition care process (NCP) in a Stage 5 chronic renal failure, hypertensive outdoor patient. The objective was to provide medical nutrition therapy to the patient to delay the progression of the disease and improve the quality of life. Patient education was emphasized during every diet counseling session. The patient progressed through nutrition care as indicated in the plan of care, with improvement. NCP was used to document and manage nutrition care and involves four steps: nutrition assessment and reassessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation.

The American academy of nutrition introduced the nutrition care process (NCP) in 2003. The introduction of nutrition care process has resulted in achievement of higher quality of care due to reduction in variance in nutrition care, better communication due to use of standardized language, help in outcome research.Although of immense benefit, its introduction and adaptation has been slow in India. Although of immense benefit, its introduction and adaptation has been slow in India. This article aims to introduce the concept of NCP and highlight the ways in which it has been implemented in other countries. It discusses the enablers and barriers to its implementation as seen in other countries and proposes a road map to its implementation in India. Going by the reviewed literature, the major steps which would facilitate the adaptation of NCP in India would be its endorsements by leading associations of nutritionists, its introduction in the syllabus of postgraduate studies of clinical nutrition in universities, the training of practicing nutritionists by regular workshops, and the introduction and integration of apps to carry out repetitive tasks in NCP implementations in patient care.

Chronic kidney disease (CKD) is an irreversible progressive health problem often associated with cardiovascular complication, bone mineral metabolism disorder, uremic toxin deposition, and immune dysregulation. The gut microbiome is an important modulator of immune function and performs a plethora of functions inside the host body. Several factors such as diet, antibiotic use, environmental pollutant modulates the composition of Gut microbiota. An intervention with dietary substances may be a therapeutic strategy to modulate the healthy Gut microbiota composition and slowing the progression of CKD.

Coronavirus (CoV) disease 2019 (COVID-19) is defined as illness caused by a novel CoV first identified amid an outbreak of respiratory illness cases in Wuhan, China. Data provided by the World Health Organization Health Emergency Dashboard (September 16, 2020) reports 29,444,198 confirmed cases worldwide since the beginning of the epidemic of which 931,321 cases have been fatal. No drugs or biologics have proven to be 100% effective for the prevention or treatment of COVID-19 so far. Glycyrrhizin (GL) is one of the major compounds isolated from the roots of licorice. Many studies have confirmed the antiviral activity of GL. GL is an effective antiviral compound against hepatitis C virus, HIV, CVB3, DHV, EV71, CVA16, HSV, and H5N1 by weakening virus activity, such as inhibiting virus gene expression and replication, reducing adhesion force and stress, and reducing HMGB1 binding to DNA. The primary areas of concern are the regulation of dosage, hypokalemia, toxicity, drug interactions, routes of administration, and blood pressure management. Does licorice needs more studies on COVID-19 patients to demonstrate its merit and does licorice have some promise as an adjuvant if not cure for COVID-19 pandemic.

The term of nutcracker phenomenon describes the entrapment of the left renal vein (LRV) between the superior mesenteric artery and the aorta without accompanying symptoms. The clinical term of nutcracker syndrome corresponds to the additional presence of symptoms. It is a rare anatomical and functional disorder that appears mainly with hematuria and left kidney pain and may be accompanied by albuminuria and pelvic congestion syndrome with varicose veins. It is diagnosed primarily by Doppler ultrasound where the main parameters are the anteroposterior diameter and the flow velocity in the dilated LRV and secondarily by computed tomography where the characteristic finding is the “beak sign” at the site of the stenosis. Therapeutically, surveillance or conservative management is initially chosen due to the high probability of spontaneous remission, while in a persistent and intense clinical picture, the main treatment options are the placement of an endovascular stent and the transposition of the LRV.

Online since 1^st November 2017.