Implementation of standardized nutrition guidelines by renal dietitians is associated with improved nutrition status
Campbell, Katrina L., Ash, Susan, Zabel, Rachel, Mortimer, Catherine, Juffs, Philip, & Bauer, Judith D. (2009) Implementation of standardized nutrition guidelines by renal dietitians is associated with improved nutrition status. Journal of Renal Nutrition, 19(2), 136 -144. (In Press)
Objective: Standardized nutrition guidelines that focus on a nutrition care process have been used by dietitians
treating renal patients in Australia for over 3 years. We show the impact of this implementation on the nutritional
status of a cohort of hemodialysis patients.-----
Design: We conducted a retrospective observational study, investigating a cohort of maintenance hemodialysis
patients after the implementation of a systematic approach to the patient's nutritional care.-----
Setting: This stuffy took place in public and private in-center hemodialysis units.-----
Patients: Patients included a cohort of 65 maintenance hemodialysis patients (mean age 6 SD, 64 6 15 years;
58% male; dialysis vintage median [interquartile range], 22 [10 to 46] months).-----
Interventions: All participants were provided with a dietary interview at least every 6 months, with intensive followup
where required, and were monitored monthly regarding weight and biochemistry. Outcomes were assessed
annually between May 2004 and December 2006, after the implementation of this model of care.
Main Outcome Measure: Energy and protein intake according to dietary interview, nutritional status according to
subjective global assessment, and data regarding dry weight and biochemistry (including albumin, potassium, and
phosphate) were collected by the dietitian at each facility. Change in each outcome measure over time was assessed
using repeated-measures analysis.-----
Results: The proportion of patients with malnutrition (subjective global assessment B or C) decreased from 14% at
baseline to 3% after 2 years. Serum albumin, potassium, and dry weight remained stable throughout the study period,
and there was a significant decrease in serum phosphate over time (mean6SD,1.860.5 to 1.560.5 mmol/L, P
5 .004). Dietary energy and protein intake changed significantly over the study period (P 5 .001 and P 5 .022,
respectively), with the highest mean intake recorded during the final follow-up assessment.-----
Conclusions: The implementation of a systematic approach to patient care, in line with nutrition management
guideline recommendations, was associated with an improvement in nutritional status and dietary intake in this
cohort of maintenance hemodialysis patients, without the need for increased resources or dietitian time.
2008 by the National Kidney Foundation, Inc.
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|Item Type:||Journal Article|
|Keywords:||Nutrition guidelines, Renal Dietitians, Nutrition Status|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100)|
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100) > Nutrition and Dietetics not elsewhere classified (111199)
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health|
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
|Copyright Owner:||Copyright 2009 Elsevier|
|Deposited On:||20 May 2009 08:38|
|Last Modified:||01 Mar 2012 00:04|
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