scholarly journals Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2020 ◽  
Author(s):  
Christina L. Nelms ◽  
Vanessa Shaw ◽  
Larry A. Greenbaum ◽  
Caroline Anderson ◽  
An Desloovere ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Nutritional Status ◽  
Clinical Judgment ◽  
Nutritional Assessment ◽  
Kidney Diseases ◽  
Nutrition Status ◽  
Low Grade ◽  
Practice Recommendations ◽  
American Academy Of Pediatrics ◽  
Research Recommendations

AbstractIn children with kidney diseases, an assessment of the child’s growth and nutritional status is important to guide the dietary prescription. No single metric can comprehensively describe the nutrition status; therefore, a series of indices and tools are required for evaluation. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. Herein, we present CPRs for nutritional assessment, including measurement of anthropometric and biochemical parameters and evaluation of dietary intake. The statements have been graded using the American Academy of Pediatrics grading matrix. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. Audit and research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.

scholarly journals Energy and protein requirements for children with CKD stages 2-5 and on dialysis–clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2019 ◽  
Vol 35 (3) ◽  
pp. 519-531 ◽  
Author(s):  
Vanessa Shaw ◽  
Nonnie Polderman ◽  
José Renken-Terhaerdt ◽  
Fabio Paglialonga ◽  
Michiel Oosterveld ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Judgment ◽  
Pediatric Nephrology ◽  
Low Grade ◽  
Poor Growth ◽  
Protein Requirements ◽  
Practice Recommendations ◽  
Additional Protein ◽  
The Individual ◽  
Research Recommendations

AbstractDietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2–5 and those on dialysis (CKD2–5D). We address energy requirements in the context of poor growth, obesity, and different levels of physical activity, together with the additional protein needs to compensate for dialysate losses. We describe how to achieve the dietary prescription for energy and protein using breastmilk, formulas, food, and dietary supplements, which can be incorporated into everyday practice. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgment. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

scholarly journals The dietary management of potassium in children with CKD stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2021 ◽  
Vol 36 (6) ◽  
pp. 1331-1346
Author(s):  
An Desloovere ◽  
José Renken-Terhaerdt ◽  
Jetta Tuokkola ◽  
Vanessa Shaw ◽  
Larry A. Greenbaum ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Judgment ◽  
Dietary Assessment ◽  
Poor Quality ◽  
Low Grade ◽  
Dietary Management ◽  
Healthy Children ◽  
Potassium Intake ◽  
Practice Recommendations ◽  
Dietary Potassium

AbstractDyskalemias are often seen in children with chronic kidney disease (CKD). While hyperkalemia is common, with an increasing prevalence as glomerular filtration rate declines, hypokalemia may also occur, particularly in children with renal tubular disorders and those on intensive dialysis regimens. Dietary assessment and adjustment of potassium intake is critically important in children with CKD as hyperkalemia can be life-threatening. Manipulation of dietary potassium can be challenging as it may affect the intake of other nutrients and reduce palatability. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) for the dietary management of potassium in children with CKD stages 2–5 and on dialysis (CKD2–5D). We describe the assessment of dietary potassium intake, requirements for potassium in healthy children, and the dietary management of hypo- and hyperkalemia in children with CKD2–5D. Common potassium containing foods are described and approaches to adjusting potassium intake that can be incorporated into everyday practice discussed. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs, based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.

scholarly journals Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2020 ◽  
Vol 36 (1) ◽  
pp. 187-204
Author(s):  
Lesley Rees ◽  
◽  
Vanessa Shaw ◽  
Leila Qizalbash ◽  
Caroline Anderson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Growth Parameters ◽  
Tube Feeding ◽  
Low Grade ◽  
Enteral Tube Feeding ◽  
Practice Recommendations ◽  
The Individual ◽  
Disease Stages

AbstractThe nutritional prescription (whether in the form of food or liquid formulas) may be taken orally when a child has the capacity for spontaneous intake by mouth, but may need to be administered partially or completely by nasogastric tube or gastrostomy device (“enteral tube feeding”). The relative use of each of these methods varies both within and between countries. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) based on evidence where available, or on the expert opinion of the Taskforce members, using a Delphi process to seek consensus from the wider community of experts in the field. We present CPRs for delivery of the nutritional prescription via enteral tube feeding to children with chronic kidney disease stages 2–5 and on dialysis. We address the types of enteral feeding tubes, when they should be used, placement techniques, recommendations and contraindications for their use, and evidence for their effects on growth parameters. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgement. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

Association between feeding patterns and nutritional status of the under five children (6-59 months) in Mtwara Rural District, Tanzania

2019 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
D. Nicodemas ◽  
L.W.T. Fweja ◽  
S.H. Magoha
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Dietary Diversity ◽  
Rural District ◽  
Nutrition Status ◽  
Consumption Pattern ◽  
Z Score ◽  
Feeding Patterns ◽  
Under Five ◽  
Under Five Children

This study was conducted to determine the association between feeding pattern and nutritional status of the under-five children in Mtwara rural district. Nutritional assessment information was collected using three survey tools: food frequency survey, 24 hours diet survey and anthropometric assessment survey. Anthropometric measures of weight and height were used to assess the nutritional status and WHO Anthro Plus was used to compute the anthropometric data to obtain Height for Age Z-score, Weight for Age Z-score and Weight for Height Z-score. The questionnaire was administered to mothers / caregivers of 329 children aged 6 -59 months.  The children’s feeding patterns were determined using the 24-hour dietary recall.  Dietary diversity score was computed to understand the quality of the diet consumed by the children. Data were analyzed using IBM SPSS Statistics version 20.0 using descriptive statistics. Chi-square was used to determine the association between nutrition status and the independent variables including gender. The findings indicated 41% stunting rate, 18.8% underweight and 7.3% wasting implying poor nutrition. The cassava feeding frequencies varied among households and between and within the two children age groups, (6 – 10 months) and (11-59 months). Overall 87.23% of children (6-59 months) had a feeding frequency of 2 days, 3 days or 6 days in a week. The dietary diversity indicated an average IDDS of 2.5 implying poor diversity of consumed food groups which was similarly far below the target IDDS of 5 established for this study. The results however indicated no significant association (p ≥ 0.05) between cassava consumption pattern and prevalence of stunting, wasting and underweight and also between gender and nutrition status. The high prevalence rate of malnutrition could thus be attributed to a synergistic effect of several factors.

scholarly journals Urban-rural differentials in nutritional status of ageing in Bangladesh

2021 ◽  
Vol 8 (2) ◽  
pp. 558
Author(s):  
M. Taj Uddin ◽  
Momduha Akter ◽  
Mohammad Kamal Hossain ◽  
Mohammad Ali Raju ◽  
M. Shah Noor
Keyword(s):  
Nutritional Status ◽  
Rural Area ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Good Health ◽  
Rural Elderly ◽  
Nutrition Status ◽  
Urban Elderly ◽  
Chi Square

Background: The growth rate of elderly is the fastest in most of the developing countries including Bangladesh. Nutrition plays fundamental role in maintaining good health especially in old age. This study was an attempt to assess the nutritional status of elderly and to compare it with their location.Methods: A total of 400 elderly in urban and rural area of Sunamgonj district have been interviewed through a structured questionnaire during July to September, 2019. A person aged 60 and above is included in the sample. Body mass index (BMI), mini nutritional assessment (MNA) short form, descriptive statistics, and Chi square test for association have been used for data analysis.Results: The analysis revealed that 17 percent elderly were under-weight, 66 percent were normal nutrition, 13 percent were over-weight and 4 percent were obese. The prevalence of malnutrition was found to be 40 percent. The rural elderly were at more risk of being malnourished compared to urban elderly. The mean BMI and MNA score of urban elderly were significantly different from the rural elderly.Conclusions: The findings show that more proportion of urban elderly are over-weight and obese compared to rural elderly. Therefore, measures should be taken to improve the nutrition status of elderly especially in rural area. 

scholarly journals The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis—clinical practice recommendation from the Pediatric Renal Nutrition Taskforce

2019 ◽  
Vol 35 (3) ◽  
pp. 501-518 ◽  
Author(s):  
Louise McAlister ◽  
Pearl Pugh ◽  
Laurence Greenbaum ◽  
Dieter Haffner ◽  
Lesley Rees ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Judgment ◽  
High Morbidity ◽  
Low Grade ◽  
Dietary Management ◽  
Healthy Children ◽  
Vitamin D Levels ◽  
Practice Recommendation ◽  
Skeletal Complications ◽  
The Common

AbstractIn children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2–5 and on dialysis (CKD2-5D), describing the common Ca- and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo- and hypercalcemia and hyperphosphatemia. The statements have been graded, and statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.

scholarly journals DENTITION AND MALNUTRITION RISK IN COMMUNITYDWELLING OLDER ADULTS

2018 ◽  
pp. 1-8
Author(s):  
R. Zelig ◽  
L. Byham-Gray ◽  
S.R. Singer ◽  
E.R. Hoskin ◽  
A. Fleisch Marcus ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Nutrition Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.

scholarly journals Impact and Clinical Implications of the Cognitive Function and Nutritional Assessment at Admission on Hospital Outcomes and Mortality in Acutely Ill Geriatric Patients

2020 ◽  
Author(s):  
Hiroshi Yamamoto ◽  
Kenichi Ogawa ◽  
Toshifumi Morooka ◽  
Yasushi Hisamatsu ◽  
Tatsuya Ishitake
Keyword(s):  
Cognitive Function ◽  
Nutritional Status ◽  
Cognitive Dysfunction ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Cognitive Test ◽  
Nutrition Status ◽  
Hospital Outcomes ◽  
The Impact

Abstract Background The nutritional and mental status of older patients are closely related and may serve as an indicator of hospital outcomes and early nutrition interventions.Objective We aim to appraise the impact on mortality and hospital outcomes by the revised simplified short-term memory recall test (STMT-R) and the short-form mini-nutritional assessment (MNA-SF) simultaneous at admission.Methods The subjects were 727 acute inpatients with ≥50 years of age from December 2014 to September 2015. Following the collection of clinical data (base illness, length of stay, etc.), survival was subsequently measured for 4-5 years until September 2019. An STMT-R score of ≤4 and MNA-SF score ≤7 were considered to indicate cognitive dysfunction and malnourishment respectively. Cox’s proportional hazards regression models were used to evaluate the hazard of death according to the severity of dementia and the nutrition status, with adjustment for potential covariates. Survival was estimated using the Kaplan-Meier method.Results The mean age of the study population was 78.9 years old, and 52.7% of the patients were female. 118 patients could not complete the cognitive test (Incomplete Testing Group [ITG]). 385 and 224 patients were classified into the cognitive dysfunction (CDG) and non-cognitive dysfunction groups (NCDG), respectively. 370, 299 and 58 patients were classified into the “malnourished” (MNG), “at risk of malnutrition” (ARNG) and “well-nourished” (WNG) groups, respectively. A poor cognitive function and poor nutritional status at admission were associated with worse clinical indicators. 276 patients (38.0%) died during the 4 to 5 years of follow-up. The risks of mortality in the ITG, CDG and MNG was 3.88 (hazard ratio; 95% confidence interval: 2.57-5.98), 1.84 (1.28-2.72) and 4.22 (1.76-13.9), respectively. In addition, the cumulative survival rate was 23.6% for the combination of advanced dementia and malnutrition, but 51.0% for moderate dementia and malnutrition. Even undernourishment may improve the prognosis of patients with mild to moderate cognitive impairment.Conclusion The early simultaneous measurements of the cognitive function and nutritional status is expected to be useful for predicting the the hospital prognosis, mortality and the effects of early comprehensive nutritional intervention in acute elderly patients with cognitive decline.

A CROSS SECTIONAL STUDY ON NUTRITIONAL STATUS OF ELDERLY POPULATION IN A RURALAREA OF WEST BENGAL USING MNA SCREENING TOOL.

2021 ◽  
pp. 73-75
Author(s):  
Nirmalya Manna ◽  
Saikat Bhattacharya ◽  
Rahul Biswas ◽  
Soumitra Mondal ◽  
V. Abinesh
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Nutrition Status ◽  
Sectional Study ◽  
Cross Sectional ◽  
Permanent Resident ◽  
Baseline Information

Malnutrition, or under nutrition, is a frequent and often unrecognized problem in older adults. It can result in immune dysfunction; poor wound healing, anaemia, longer hospitalization and higher readmission rates, delayed recovery from surgery and a higher rate of mortality. Current statistics for the elderly in India gives a prelude to a new set of medical, social, and economic problems that could arise if a timely initiative in this direction is not taken by the program managers and policy makers. A community based observational, descriptive cross-sectional study was conducted among the elderly people residing at Banspole sub-centre area to nd out their nutritional status. Geriatric people who were the permanent resident of the study area for at least six months were included in the study. A proforma was used to collect the baseline information of the study subjects and details of factors inuencing nutrition status. Mini nutritional assessment (MNA) tool was used to assess nutritional status of 2 elderly. 300 elderly patients were included in this study with an average age of 77.29 ± 6.97 years and BMI of 23.67 ± 3.49 kg/m . Age, literacy and nancial status were found to be signicantly associated with malnutrition. Geriatric nutritional assessment should be integrated into a comprehensive geriatric assessment. Regular assessment of the nutritional status among elderly followed by early interventions will improve the health outcomes, prevents the onset of disability, improves quality of life and saves healthcare costs.

scholarly journals Comparison of Portuguese and Turkish older adults’ nutritional status assessed by MNA-FF

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Bruno M. P. M. Oliveira ◽  
Meryem Elif Öztürk ◽  
Rui Poínhos ◽  
Cláudia Afonso ◽  
Nurcan Yabancı Ayhan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Tooth Loss ◽  
Nutritional Assessment ◽  
Kidney Diseases ◽  
Demographic Data ◽  
Mini Nutritional Assessment ◽  
Cross Sectional Study ◽  
Calf Circumference ◽  
Cross Sectional

AbstractMalnutrition is associated to a progressive decline in health, reduced physical and cognitive functional status and mortality. However, the malnutrition prevalence differs across countries. Previous studies reported 19% of malnourished elderly in Turkey and 1.3% in Portugal.We aimed to compare the nutritional status between between Portuguese and Turkish older adults using the Mini-Nutritional Assessment.This is a cross-sectional study using data from the Pronutrisenior project, collected in Vila Nova de Gaia, Portugal (n = 430), and a study in Ankara, Turkey (n = 162). The sample consisted of older adults living at their homes. Socio-demographic data, clinical data from the medical records, the full form of Mini-Nutrititional Assessment, MNA-FF and anthropometry (weight, height, BMI, mid-arm circumference and calf circumference) were collected.Turkish older adults lived more frequently with children, are more likely to be widow/widower, and have a higher probability of being housewife/househusband. A larger proportion of the Portuguese have tooth loss, diabetes, hypertension, oncologic diseases, kidney diseases, osteoarticular problems, or eye problems and a larger proportion of the Turkish have anemia. The BMI average is smaller in the Turkish sample, while the calf circumference average is larger. Turkish have a larger proportion of malnourished or at risk of malnutrition (4.9% and 31.5% vs. 1.2% and 24.0%, respectively). The average MNA-FF score is higher among the Portuguese, males and on people using denture, and without: toothloss, hypertension, CVD, anemia and oncological diseases. Moreover, higher MNA-FF scores were associated with younger ages, higher BMI and higher calf circumference.The effect size was larger for CVD and sex.The prevalence of malnutrition in European and American populations ranges from 1% to 15% in ambulatory living elders, more common among females as in this work. Other studies showed that higher BMI is related with lower malnutrition prevalence and higher prevalence of obesity-related chronic diseases. Tooth loss was more frequent in the Portuguese, which may be due to a higher intake of sweets or packaged food. Portuguese elders had lower calf circumferences but higher BMI, which may be related to lower muscle mass and/or higher fat mass. The differences between the Portuguese and the Turkish may be related to the different per capita gross national product, positively correlated with BMI and the consumption of processed foods. Anemia in Turkish elders may be related with BMI and their lower consumption of meat and the higher tea intake that may reduce iron absorption, as reported by other studies.

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