Table 1 Routine of nutritional care
Forwarding Order: nephrologists to dietitians Biochemical mandatory measurements: GFR and albuminuria Biochemical additional measurements: lipid and glycemic profile |
Patients Target: all referred patients, except palliative cancer patients (<6 months of life expectance) |
Diet Type: adapted to Brazilian eating habits and patient´s food preferences Energy intake: approximately 30 to 35 kcal/kg/day Protein intake: approximately 0.6 to 0.8 g/kg/day Nutrient calculation: own software with foods arranged in standard servings per food groups Replacement list of food: available Estimation of portion sizes by measuring tools and photograph albums Recipes with low protein content |
Outpatient organization First nutritional appointment * survey of demographic, clinical, socio-economic and biochemical data * nutritional status evaluation (BMI, %BF, MAC, WC) * assessment of food intake (24-h food recall) * explanation of the goals of nutritional counseling and delivery of a book with dietary guidelines about protein, potassium and salt intake Second nutritional appointment (one week later) * Personalized nutritional plan Subsequent nutritional appointments (one, two or three months apart) * nutritional status evaluation * LPD adherence evaluation (24-h food recall, biochemical measurements and PNA) * Adjustments of dietary prescriptions, if necessary |