Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Nutrition 3 > Renal Transplant > Flashcards

Renal Transplant Flashcards

1
Q

Why do we suspect kidney disease is on the rise?

A

As the etiologies leading to CKD, such as diabetes and hypertension are also on the rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Patients who get a kidney transplant before dialysis live an average of ____ years longer than if they stayed on dialysis

A

10-15 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the nutritional pre-transplantation goal?

A

To optimize nutritional status to decrease:

  • Surgical risk
  • Post surgical complications
  • Length of hospital stay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Both ____ and ______ nutrition can increase risk of post-surgical complications

A

Under and over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In over nutrition, obese patients have what disadvantaged?

A
  • Higher mortality rate
  • Lower graft function
  • Incr. incidence of wound complications
  • More frequent ICU admissions
  • More frequent intubations
  • Increased incidence of post-transplant diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In the acute post-transplant phase, what is the nutritional priority?

A
  • To manage the increased metabolic demands of surgery

- And to address unwanted side effects of immunosuppressive drugs (Which patients will be on for life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The immunosuppressive drug, cyclosporin, has what undesirable side-effects?

A
  • Gingival hyperplasia
  • GI disturbances
  • HyperG
  • Gynecomastia
  • Hepatotoxicity
  • Nephrotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which side effect of immunosuppresive drugs will decrease glycogen synthesis?

A

Hepatoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is used to inhibit the production of lymphokines?

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side effects of corticosteroids?

A
  • Impaired wound healing
  • Avascular necrosis of long bones
  • Upper GI ulceration
  • Protein catabolism
  • Hypertension
  • Steroid induced diabetes
  • Stimulation of appetite, weight gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the typical post-transplant protein and energy needs?

A

Will increase for up to 6-8 weeks post-op dye to stress and excessive doses of corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Discuss CHO implications in the post-transplant patient

A

-Often glucose intolerance and insulin resistance secondary to hyperglycemia by corticosteroids and immunosuppressive drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can we adjust CHOs to minimize the risk of developing steroid-induced diabetes?

A

Emphasize on complex carbohydrates, dietary fibres etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fat in post-transplant patients?

A

25-25% of total energy

  • Max SFA of 7%
  • Remaining are MUFA and PUFA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Should sodium be restricted in renal transplants?

A

Yes, as HTN is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the implication of potassium and transplants?

A

Hyperkalemia can be induce by poor graft function, impaired potassium excretion and potassium-sparing diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should potassium be spared?

A

In the acute period and chronic period if hyperkalemia

18
Q

what should be avoided if taking immunosuppressive drugs tacrolimus and cyclosporine?

A

Avoid grapefruit and grapefruit juice

19
Q

When is the acute phase?

A

Up to 8 weeks post-transplant and during acute rejection

20
Q

When is the chronic phase?

A

After 8 weeks

21
Q

Acute phase protein?

A

1.3-2.0 g/kg/day

22
Q

Chronic phase protein?

A

0.8-1.0 g/kg/day with functioning transplant

23
Q

Acute phase kcals?

A

30-35 kcal/kg

24
Q

Chronic phase kcals?

A

25-35 kcal/kg to maintain desirable weight

25
Q

Acute phase CHO?

A

50-70% non-protein calories

26
Q

Chronic phase CHO? How many g of fibre in female? Males?

A
  • 45-50% of kcals with focus on complex CHO
  • 25g/day female
  • 30 g/day male
27
Q

Acute phase fat?

A

30-50% non-protein calories

28
Q

Chronic phase fat?

A

25-35% of total kcal with SFA <7% total kcal

29
Q

Acute phase potassium?

A

Unrestricted, if hyperK <2.4 g/day

30
Q

Chronic phase potassium?

A

No restriction unless hyperK

31
Q

Acute phase calcium?

A

1000-1500 mg

32
Q

Chronic phase calcium?

A

2000 mg

33
Q

Phosphorusm, vitamins/minerals and trace elements during the acute and chronic phase?

A

To meet RI

34
Q

Acute phase fluids?

A
  • Ad lib
  • 1ml/kg dry weight
  • Match output unless diuresis is goal
35
Q

Chronic fluid ?

A

-Ad lib with functioning transplant

36
Q

Two common side-effects in the post-transplant patient?

A
  • CVD
  • Hypomagensemia
  • Obesity
  • CKD-BMD
  • Rejection
37
Q

Why is CVD risk increased post-transplant?

A

Dyslipidemia’s are common in 70% of patients

38
Q

Why is hypomg common post-transplant?

A
  • Often associated with cyclosporine and tacrolimus use

- IV replacement may be required

39
Q

Nutritional intervention in CKD BMD?

A

-Calcium supplementation, vitamin D and anti-resorptive agents may be needed

40
Q

What is needed early posttransplant?

A

Phosphate supplementation, as hypophosphatemia occurs in 50% of patients

41
Q

What happens during rejection?

A

Many corticosteroids administered, which means protein and energy requirements increase

42
Q

What is the bottom line role of dietitians in renal transplant patients?-

A

1) Prevent and treat PEM
2) Prevent and treat mineral and electrolyte disorders
3) Reduce the impact of other co-morbidities
4) Improve patient quality of life

Clinical Nutrition 3 (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions