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Laboratory Data in nutrition assessment

1 meql acute or chronic renal failure assessment for

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Unformatted text preview: loss, gastric suctioning, vomiting vomiting Renal losses: osmotic diuresis, DM with glucosuria, Renal correction of DKA, renal disease with magnesium wasting, hypophosphatemia, hypercalcemia, hyperthyroidism hypophosphatemia, Alcoholism Inadequate intake: malnutrition Medications Intracellular shift: acute pancreatitis Refeeding syndrome Hypermagnesemia (>2.1 mEq/L) • Acute or chronic renal failure Assessment for Protein-Calorie Malnutrition • • Hormonal and cell-mediated response Hormonal to stress to • Negative acute-phase respondents • Positive acute-phase respondents Nitrogen balance Assessment for Protein-Calorie Malnutrition–cont’d • Hepatic transport proteins • Albumin • • • • Retinol-binding protein C-reactive protein Creatinine Immunocompetence • • Transferrin Prealbumin Hormonal and Cell-Mediated Response to Inflammatory Stress • • • Acute illness or trauma causes Acute inflammatory stress inflammatory Cytokines (interleukin-1, interleukin-6 Cytokines and tumor necrosis factor) reorient hepatic synthesis of plasma proteins hepatic Although protein-energy malnutrition can Although occur simultaneously, interpretation of plasma proteins is problematic plasma Hormonal and Cell-Mediated Response to Inflammatory Stress • • • Negative acute-phase respondents Negative (albumin, transthyretin or prealbumin, transferrin, retinol-binding protein) decrease decrease Positive acute-phase reactants (C-reactive Positive protein, orosomucoid, fibrinogen) increase increase The change in these proteins is The proportional to the physiological insult proportional Nitrogen Balance Studies • • • Oldest biochemical technique for Oldest assessment protein status assessment Based on the fact that 16% of protein is Based nitrogen nitrogen Nitrogen intake is compared to nitrogen Nitrogen output, adjusted for insensible losses (skin, hair loss, sweat) Nitrogen Balance Studies • • • Nitrogen balance in healthy adults is 0 Nitrogen balance is positive in growing Nitrogen children, pregnant women,...
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