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Dialysis

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Book cover Nutrition in Kidney Disease

Part of the book series: Nutrition and Health ((NH))

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Abstract

Medical nutrition therapy (MNT) plays an integral role in the health of the patient with Stage 5 chronic kidney disease (CKD) receiving maintenance dialysis. The health professional must understand the role of nutrition in Stage 5 CKD, the factors affecting assessment and maintenance of adequate nutritional status, and the nutritional implications associated with the different types of renal replacement therapies (RRT). Currently there are almost 400,000 patients receiving RRT in the United States with those numbers expected to steadily increase [1, 2]. The average age of the patient starting dialysis is increasing with a significant number of patients presenting to dialysis with numerous comorbid conditions that may have already negatively impacted their nutritional status. The nutritional status of the patient at the initiation of RRT is an important risk factor for future outcomes, and malnutrition is associated with increased mortality in patients receiving maintenance dialysis [3]. Nutritional management should include ongoing diet education, nutrition assessment, individualized interventions, and monitoring of nutritional status. The goals of MNT in Stage 5 CKD are (a) to achieve and maintain neutral or positive nitrogen balance, (b) to achieve and maintain good nutritional status, (c) to prevent the accumulation of electrolytes and minimize fluid imbalance, and (d) to minimize the effect of metabolic disorders associated with Stage 5 CKD.

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Acknowledgment

Although Dr. Graeme Mendel did not contribute to the chapter in this edition, his previous contribution is invaluable and has been left largely intact.

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Authors and Affiliations

  1. Geisinger Health System, Danville, PA, 17821, USA

    Karen Wiesen M.S., R.D., L.D.N

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  1. Karen Wiesen M.S., R.D., L.D.N
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Correspondence to Karen Wiesen M.S., R.D., L.D.N .

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Editors and Affiliations

  1. Dept. Primary Care, University of Medicine & Dentistry, New Jersey, Stratford, New Jersey, USA

    Laura D. Byham-Gray

  2. Dept. Nutrition, Long Island University C.W. Post Campus, Brookville, New York, USA

    Jerrilynn D. Burrowes

  3. Div. Nephrology, Stanford University School of Medicine, Stanford, California, USA

    Glenn M. Chertow

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Wiesen, K. (2014). Dialysis. In: Byham-Gray, L., Burrowes, J., Chertow, G. (eds) Nutrition in Kidney Disease. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-685-6_11

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  • DOI: https://doi.org/10.1007/978-1-62703-685-6_11

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-684-9

  • Online ISBN: 978-1-62703-685-6

  • eBook Packages: MedicineMedicine (R0)

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