What is the best predictor of declining nutritional status in early kidney failure? (2001 CD)
The best predictor of declining nutritional status in early kidney failure is a GFR <60 ml/min. A GFR <60 ml/min is associated with decreases in the laboratory parameters of hemoglobin, serum albumin and bicarbonate, decreases in body weight/BMI and decreases in dietary intakes of protein and energy. Studies of various design (randomized controlled trials, cohort, nonrandomized controlled trials, and cross-sectional studies) have shown similar results. Therefore, patients with a GFR <60 ml/min/1.73 m2 should undergo a nutrition assessment to evaluate for protein calorie malnutrition followed with appropriate intervention.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.