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  Citation statistics : Table of Contents
   2019| October-December  | Volume 5 | Issue 4  
    Online since June 9, 2020
 
 
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SHORT REVIEW
Assessment and management of nutrition in hemodialysis patients
Anil Kumar Bhalla, Vinant Bhargava, Priti Meena
October-December 2019, 5(4):83-87
DOI:10.4103/jrnm.jrnm_3_20  
Malnutrition is prevalent in patients on hemodialysis. About 18%–75% of patients with chronic kidney disease, undergoing maintenance dialysis, show evidence of wasting. The genesis of malnutrition in hemodialysis patients is multifactorial and comprises reduced dietary nutrient intake, metabolic derangements associated with uremia, and the adverse effects of hemodialysis and other concurrent morbid conditions. In spite of much progress done in recent years in recognizing the pathomechanistic link between malnutrition and mortality, consensus regarding the therapeutic strategies to deal with nutrition-related clinical problems is lacking. Protein–energy wasting (PEW) is the most influential risk factor for adverse outcomes and death. Nutritional supplementation (orally or parenterally) is useful in the management of PEW.
  1 3,836 351
CASE REPORT
A missed cause of abdominal pain and malnutrition in autosomal dominant polycystic kidney disease
Rudreshwar Prabakaran, Jasmine Sethi, Smita Divyaveer, Balamurugan Thirunavukkarasu, Amanjit Bal, HS Kohli
October-December 2019, 5(4):79-82
DOI:10.4103/jrnm.jrnm_4_20  
A 62-year-old lady having autosomal dominant polycystic kidney disease (ADPKD) with gradual progression of chronic kidney disease (CKD) to end-stage renal disease presented with anorexia and dull-aching continuous abdominal discomfort. She had no response to conservative management and was started on maintenance hemodialysis. She followed up 3 months later. Her symptoms had only marginally improved initially despite continuing dialysis, and she continued to be malnourished. She presented to the emergency department with worsening abdominal pain and obstipation. Contrast-enhanced computed tomography abdomen was done which showed signs of abdominal tuberculosis with bowel obstruction. She was taken up for surgery. On postoperative day 2, she had refractory septic shock and cardiac arrest and could not be revived. Dull-aching chronic abdominal pain in ADPKD is common and is attributed to increased kidney sizes. With progression of CKD to uremia, anorexia is common. However, other causes of abdominal pain and malnutrition may be overlooked. In our case, the patient had abdominal tuberculosis which was the cause of persistent anorexia and malnutrition. Close follow-up of nutritional status and evaluation of malnutrition in patients with CKD is of paramount importance.
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CLASSROOM READING
What augments nutritional support in acute kidney injury?
Anita Saxena
October-December 2019, 5(4):88-90
DOI:10.4103/jrnm.jrnm_8_20  		   - 2,382 172
CLINICAL PRACTICES
At glance translating clinical practice guidelines for mineral bone disease in chronic kidney disease into practice
Abhilash Chandra, Anita Saxena
October-December 2019, 5(4):91-92
DOI:10.4103/jrnm.jrnm_9_20  		   - 2,156 178
Practical approach to a patient with acute kidney injury
Anita Saxena
October-December 2019, 5(4):93-96
DOI:10.4103/jrnm.jrnm_7_20  		   - 2,075 197
EDITORIAL
How aggressive are we in providing nutritional support to patients with acute kidney injury?
Anita Saxena
October-December 2019, 5(4):77-78
DOI:10.4103/jrnm.jrnm_10_20  		   - 2,333 217

Online since 1st November 2017.