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Offering a pencil and paper option or tracking on a smart phone provides your patient with different methods to obtain this information. While the value of the RD is not news, the guidelines further support our role and importance as part of the int er disciplinary team. Through prescription of individualized and tailored MNT, the RD can optimize nutritional outcomes and support the patient with CKD and other comor b idities.
Adequate intake for the patient is necessary and increases in importance with disease progression to prevent protein-energy wasting often seen with later stages of CKD. Newer KDOQI guidelines reflect ranges for protein and energy intake to help optimize nutritional status with this population. In metabolically stable individuals with CKD 3 to 5, not on dialysis and without diabetes, the following for protein is recommended:.
In CKD 3 to 5 patients with diabetes who are not on dialysis, the protein recommendation is slightly increased:. Dialysis patients, with and without diabetes, due to numerous factors , have greater protein needs:. When assessing the protein needs of your CKD patient, the use of clinical judgement is also necessary.
In addition, for patients with diabetes, the daily goal for protein may need to be adjusted to help regulate blood glucose levels. Optimal energy can be difficult to predict in this patient population due to the lack of a validated resting energy equation. In place of this, a range of recommendations is provided for metabolically stable adults with CKD Stages D and post-transplant:. Experts recommend considering age, gender, physical activity, body composition, weight status, CKD stage and comorbidities when calculating energy needs.
While actual body weight is used for the guidelines, in those individuals who are under — or overweight, clinical judgement is needed from the RD. View Leadership. Current Projects. Sign up to review upcoming guidelines. View current projects. Guideline development process.
KDOQI strives to make clinical practice guideline development as transparent and efficient as possible. It generally takes months from development of a scope of work to submission of the manuscript to AJKD. Our process.
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