Enteral Nutrition in Renal Patients with Hemodialysis and AKI cases

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There are so many questions about how to approach renal patients requiring enteral nutrition. Does everyone need a renal formula? Is refeeding syndrome still a risk? What do you do about protein for critically ill renal patients?
This video breaks down the basics of kidney function and enteral feeding, discusses all the questions above, and includes two case studies for a hemodialysis patient and an acute kidney injury patient.
Looking for more on renal nutrition support? DNS members can check out the April 2021 edition of Support Line, the DNS publication focused on clinical nutrition support care. This edition's articles include Common Medication Issues in Dialysis Patients, A Guide to Enteral Nutrition for Patients with Renal Failure, and Micronutrient Losses in Continuous Renal Replacement Therapy with a quiz for continuing education credit.
Closed captions by Katie Gengozian RDN.

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2 авг 2024

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Комментарии : 16

@-Salmondo- 2 месяца назад

Hi thank you for the video Can you please explain regarding the fluids. I don't think I fully understand why you chose the mL range for the patient.

@chochoma9842 3 года назад

😊 Thanks

@pinoydietitiansinclinicalp2683 Год назад

Do you give 30-35 kcals for intubated patients on HD? I thought that estimation is oaky for non critically ill, non intubated.

@wafareda2827 3 года назад

Thank you very well explained for the obese patient who has been years on dialysis do you use actual body weight to calculate protein needs.

@DietitiansinNutritionSupport 2 года назад

Hello! For the case patient in this video (Lester) who is considered obese, we did choose to use actual body weight for the protein needs. This is based on the KDOQI guidelines from 2020, but at the end of the day would be a clinical judgement call based on the patients overall presentation and needs. Hope that helps!

@michaeljohns6222 2 года назад

/ Thank you dr Eseigbe for using his herbs treatment to cure my kidney stone ru-vid.com/show-UCvGz1DqNpScob6MXKrACYhg /

@yileihua6013 3 месяца назад

@@DietitiansinNutritionSupport Hi, thank you for your video. It is surprising for me that you use actual BW to calculate protein needs. I work in outpatient dialysis program and would typically use ideal BW or adjusted BW when their BMI are in obese category. I was reviewing 2020 KDOQI guideline and it did not really say 1.0-1.2g/kg ACTUAL body weight... (at least I couldn't find it); it was vague when it comes which weight to use, but I did find a table that talks about measuring body weight (Table 5), and it discussed all kinds of methods to determine BW including IBW, adjusted BW etc. Is it a standard practice in your group to use actual BW to calculate protein for obese patient? What about patient that's quite edematous? thank you for your answer.

@panagiotadrakontaeidi7624 2 года назад

Thank you for the information! In case a patient who is in dialysis treatment plan has a normal BMI, what weight do we use to calculate the energy and protein needs? Αlso, does this weight change depending on the stage of treatment that the patient is in (in case of replacement therapy or peritoneal dialysis)?

@DietitiansinNutritionSupport 2 года назад

Hello! Great question. If a person had a BMI within the normal range, it would likely be appropriate to use an actual body weight so long as when the patient was clinically assessed there was not excessive fluid retention, signs of malnutrition and wasting etc. The choice of which weight to use is dependent on the current nutrition status of the patient as well as their planned therapies. Some things to consider might be whether the dialysis type contains calories (e.g., peritoneal dialysis may contain calories depending on the dialysate used), or whether it would be more appropriate to use an actual body weight but a lower or higher range of calories. Much of the decision is based on clinical judgment and the specific patient in question. Hope that helps!

@wafareda2827 3 года назад

In case patient is underweight BMI < 18 do you use IBW to calculate protein n calories thank you

@DietitiansinNutritionSupport 2 года назад

Hi, for a patient who is considered underweight, the KDOQI guidelines for individuals with kidney dysfunction recommend the use of actual body weight for protein and calorie calculations. Likely you might want to air on the higher end for goals. This is also just a starting point and you will need to evaluate the individual patient's nutrition status and adjust calculations as needed. Thanks!

@pinoydietitiansinclinicalp2683 Год назад

Hi. How did you get the 15-18 kcals x ABW for Obese patient?

@charithapoonamalli9715 Год назад

You gotta estimate. Upto my knowledge v can't give a pt more than 900 ml / day for a over weight / obessed pts

@didempark8604 2 года назад

Can I earn CEs by watching these presentations??? I am a registered dietitian.

@DietitiansinNutritionSupport 2 года назад

Hello and thanks for watching! Currently we do not have a mechanism to provide continuing education credits through our RU-vid channel. If you are a DNS member, you can get free continuing education credits by reading our Support Line publication and completing the associated quiz. As we are mostly a one person show for the RU-vid channel, the workload needed to provide continuing education credits is unfortunately beyond our capacity. We hope in the future we will be able to consider adding this benefit!