Medical Nutrition Therapy Reference Pages
Described as a serious imbalance of fluids as well as the electrolytes especially in malnourished
persons who are experiencing metabolic anomalies and who are being submitted to re-feeding.
This process is carried out either eternally orally or parenterally. It is therefore closely related to
mortality and morbidity. Clinical presentation includes anomalies in glucose metabolism, critical
fluid imbalance, hypomagnesaemia, hypokalaemia, hypophosphataemia in some instances
thiamine will be a classical feature.
Patients with renal failure will present with high levels of serum electrolyte hence a slow
response in the refeeding interventions. Maintenance of safe serum glucose levels will be
difficult for patients who are experiencing final stage of liver disease since they will be having
exhausted glycogen stores. Due to the inadequate supply of insulin in diabetic patients, the
refeeding process is critically delayed since the electrolytes and glucose are not driven in the
cells hence assisting in nutritional support.
At the lower limit potassium should be given at 3.5 significantly low at 3.0 and for critical
patients at 2.2
Phosphates should be given at 0.8 at significantly low levels 0.5 and critical patients at 0.35
Magnesium low limit should be at least 0.7 for significantly low patients 0.5 and critical patients
Daily monitoring of blood levels of magnesium, phosphates are to be measured on a daily basis,
hence adjusted as feeding progresses. Fluid imbalance should be closely assessed clinically
inclusive of glucose levels
Chronic Kidney Disease
Also referred to as chronic renal failure, chronic kidney disease refers to all degrees of reduced
renal functionalities. Hence due to the diminished rate of filtering excess wastes and fluid
retention of these wastes causes toxicity in the body system. Causative factors include diabetes
type 1&2, hypertension, obstruction of the urinary tract, recurrent pyelonephiritis, vesicouteretal,
interstitial nephritis and Glomerulonephritis.
Appropriate Factors for Estimating Needs
CKD is initially managed through the control of blood pressure this should be between 140/90
mmHg recommended pressure and 130/80 mmHg suggested pressure. Control of diabetes
mellitus acts as a control in the progression of CKD and reduces the chances of cardiovascular
morbidity. Patients who have developed should constantly undergo lipid testing which assist in
medication compatibility. Patients with CKD have been found to experiences low metabolism
rate with regard to phosphates and calcium’s. Laboratory tests are recommended very four
Diets that are low in potassium are highly recommended K > 5.5 mEq/L.
Phosphorus levels should be at 3 to 5 mg/dl.
Daily sodium intake should be at 2g per day as a pharmacotherapy it assist in the regulation of
Occurrence of Albuminuria at ≥ 30mg/24hrs through a urinalysis test, this includes investigation
of urine composition; presence of sediments. Tubular disorder indicated by electrolytes. Imaging