Assessment

Question 1

12 question tool related to appetite and food intake
Provides qualitative and quantitative dx of anorexia (total score < 30 indicates anorexia)
Performs well in HD

Answer 1

Functional Assessment of Anorexia/Cachexia Therapy (FAACT)

Question 2

Uses rating scale of 0 mm (no hunger) - 100 mm (hunger).
Quantitative “measure” of appetite but no defined cutoff for anorexia
Performs well in HD,

Answer 2

Visual Analog Scale

Question 3

What is the recommended frequency to monitor BW, BMI, and body comp. changes?

Answer 3

Dialysis: monthly
CKD 4-5, posttransplant: quarterly
CKD 1-3: q 6 months

Question 4

How to calculate ABW based on NHANES II

Answer 4

Edema-free BW + ((standard BW-edema free BW) x 0.25)

Question 5

What is the conicity index?

Answer 5

Measure of abdominal obesity
Used in CKD 5D on HD to assess nutritional status and as predictor of mortality

Question 6

What areas are assessed for subcutaneous fat loss in NFPE?

Answer 6

Below eyes
Triceps/biceps

Question 7

What areas are assessed for muscle loss in NFPE?

Answer 7

Temple
Clavicle
Shoulder
Scapula
Interosseous muscles
Knee, Quads, Calf

Question 8

What nutrient deficiencies can be assessed looking at hair?

Answer 8

Protein
Zinc
Essential fatty acids
Vitamin C

Question 9

What nutrient deficiencies can be assessed looking at skin?

Answer 9

Protein
Vitamin A
Vitamin C
Zinc

Question 10

What nutrient deficiencies can be assessed looking at nails?

Answer 10

Protein
Iron
Zinc
Essential fatty acids

Question 11

What nutrient deficiencies can be assessed looking at eyes?

Answer 11

Vitamin A
Iron (inner eyelids)

Question 12

What nutrient deficiencies can be assessed looking at the gums/lips/tongue?

Answer 12

Vitamin A (gums)
Iron (tongue)
Vitamin C (gums)
B Complex Vits. (lips, tongue)

Question 13

What are the components of Subjective Global Assessment?

Answer 13

Medical hx: progression of weight loss, eating habits, GI sx, physiological functioning, metabolic stress

Physical: loss of subcutaneous fat and muscle

Score: 6-7 (well-nourished or mild); 3-5 (mild to moderate); 1-2 (severe)

Recognized as valid and useful clinical measure of protein-energy nutr. status in dialysis

Question 14

What are the components of the Malnutrition-Inflammation Score?

Answer 14

Anthropometrics, diet intake patterns, biochemical parameters
Higher score indicates worse nutr. status