Evidence based practice guidelines for the nutritional management of cancer cachexia and chronic kidney disease

Abstract

The purpose of these guidelines is to provide dietitians in Australia with a user-friendly summary of the evidence to support the nutritional management of adult patients with cancer cachexia. This best available evidence is presented and used as a basis for providing recommendations about clinical practice.

The clinical questions were as follows:
• How should patients be identified for referral to the dietitian in order to maximise nutritional intervention opportunities?
• How should nutritional status be assessed?
• What are the goals of nutrition intervention for patients with cancer cachexia?
• What is the nutrition prescription to achieve these goals?
• Should eicosapentaenoic acid be included in the prescription?
• What are effective methods of implementation to ensure positive outcomes?
• Does nutrition intervention improve outcomes in patients with cancer cachexia?

This document is a general guide to appropriate practice to be followed only subject to the dietitian’s judgement in each individual case. The guidelines are designed to provide information to assist decision-making and are based on the best information available at the date of compilation. The guidelines recommend intensive nutrition therapy. This has potential resource implications that may include additional staff, change to staff roles and increased use of high/protein energy supplements if they are considered. Therefore, in applying the guidelines these potential organisational and cost
barriers need to be considered. These guidelines for practice are provided with the express understanding that they do not establish or specify particular standards
of care, whether legal, medical or other.