Practice Patterns Of Clinicians: Assessment Of Malnutrition In Ckd Dialysis And Interventions

With limited information on the practice patterns regarding clinician identification of malnutrition and the use of nutritional interventions in malnourished CKD-5 dialysis patients, a market research survey was conducted by NKF sponsored by Pentec Health to evaluate this amongst renal clinicians. For dialysis patients, results for the top four assessment markers were: decreased appetite; albumin level; decrease in dry weight, quality of life. Most commonly recommended oral supplements (OS) were nutritionally complete renal, diabetic and standard products with most common barriers: out of pocket cost; patient resistance; and reimbursement issues. Nutrition support and food during dialysis responses for outpatients in table below:Nutrition Intervention% of clinicians who would recommendBarriers to Use (Top 3 )Tube Feeding28.0 %Not available at unit; patient resistance; family resistanceIntradialytic Parenteral Nutrition (IDPN)48.7 %Reimbursement ; not available at unit; MD resistanceIntraperitoneal Nutrition (IPN)22.0 %Not available at unit; reimbursement; MD resistanceTotal Parenteral Nutrition (TPN)16.9 %Not available at unit; reimbursement, MD resistanceFood During Hemodialysis83.3 % OS 63.3% FoodDrop in blood pressure, risk of aspiration; hygieneFindings: A clinician gap seems to exist around nutrition support interventions in CKD-5 dialysis patients. Meal provision during dialysis could be expanded. These interventions may improve the nutritional status of dialysis patients