INTRODUCTION TO ACUTE RENAL FAILURE

Introduction
Malnutrition is a very common concomitant condition in patients with Chronic Kidney Disease (CKD). Therefore dietary support is of high importance for these patients. Malnutrition is a general term that indicates a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein, and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function, and clinical outcome1. The first and most important type is protein-energy malnutrition (PEM) or protein-energy wasting (PEW), which is defined as a lack in supply of sufficient energy or protein to meet the body’s metabolic demands2.

The causes for malnutrition are: 

  • An inadequate food intake secondary to anorexia caused by uremia and altered taste sensation
  • Renal patients although they usualy do not have increased energy expenditure, their energy needs may increase due to the effect of disease or acute illness
  • Impaired ability to prepare food
  • Unpalatable prescribed diets (low salt, fluid restriction, low potassium, low phosphorus)
  • The dialysis procedure itself due to nutrient losses (amino acids, peptides, proteins, glucose, water soluble vitamins etc)
  • Hypermetabolism due to chronic inflammation
  • Endocrine disorders due to uremia3,4

Therefore, an early detection of malnutrition risk and a detailed nutritional assessment is of paramount importance in providing optimal nutritional care to individuals with CKD of all disease stages, improving quality of life and improving the outcome of dialysis for the ones on hemo or peritoneal dialysis.

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How can we improve skills, in order to combine the right assessment with the right nutritional care, based on patients individual needs?

EDTNA/ERCA identified the gap and lack of knowledge and education about Malnutrition and approached B. Braun to start up a Collaboration Programme. The Educational Programme is about how to address the concerns to support successful development of Educational Material.

Project name - Exploring Nutrition Support Practices in Haemodialysis Units - A Guide to Implementing Best Practice

Objectives 

WHAT
Investigate common practices of nutritional screening and support
The intent is to provide insight and education about Malnutrition and to increase the awareness of Dietary intervention which is of high importance for patients with Chronic Kidney Disease (CKD)

WHY
Identify educational gaps and need for further provision of knowledge in nutrition for renal nurses
To be able to early identify and treat malnutrition, a nutritional screening is necessary, followed by a detailed nutritional assessment in order to provide optimal care to individuals with CKD

HOW
Collaboration with EDTNA/ERCA – the multi-disciplinary experts.

WHEN
Q4 2016 – Q4 2019


The Collaboration Programme was split into four Phases. 
Phase 1 - Survey
Survey
Phase 2 - The analysis of the Survey presented at the 46th EDTNA/ERCA International Conference, Krakow, Poland, September 9 -12 , 2017
Presentation
Phase 3 - Based on the analysis of the Survey - Development of an Application which was launched at the 47th EDTNA/ERCA International Conference, Genoa, Italy, September 15 - 18, 2018

Exploring Nutrition Support Practices in Haemodialysis Units - A Guide to Implementing Best Practice

The objectives of this tool are: 

  • To increase healthcare professionals’ awareness about malnutrition
  • Provide information on the benefits of Nutritional support
  • To provide an educational tool which can support the provision of nutritional support
  • To implement this knowledge into practice and to improve the patient quality of life
  • To encourage the Patient to take an informative and active part on his treatment
Application Presentation
Phase 4 - Application - additional languages to be implemented



EDUCATIONAL MATERIAL
Education & Training - this is the Core of the Association. Development of Educational materials, organize educational events like the annual International Conference and several Seminars along Europe. The aim of the Association is to provide tools and knowledge to Healthcare professionals as well as our Patients.

Publications
EDTNA/ERCA Secretariat

Källstorps Gård / Högs Byväg 118 / SE-246 55 Löddeköpinge / Sweden
Phone: +46 46 70 96 24 / secretariat@edtnaerca.org

Head Office

EDTNA/ERCA, Seestrasse 91, CH 6052 Hergiswil, Switzerland