PMID: 18711879Aug 21, 2008Paper

Risk factors affecting nutritional status of dialysis patients: a quality improvement project

Nephrology News & Issues
Linda Hopper, Marie Cole

Abstract

People with chronic kidney disease on dialysis are at very high risk for protein energy malnutrition (PEM). It is well documented that malnourished patients have increased frequency of hospital admissions, longer hospital stays, lower quality of life, and increased risk of death. Serum albumin level is a valid measure for nutritional status of PEM. Clinical practice guidelines for nutrition, established by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI), recommend that patients on dialysis achieve an albumin of 3.7 g/dL (BCP) to ensure optimal nutrition and decrease risks of PEM. At Mercy Dialysis Center, it was determined that only 6% (n=97) of patients at Mercy Dialysis Center met this recommended albumin level. This led to an extensive continuous quality improvement project to improve these results. The nephrologist, nurse practitioner, dietitian, social worker, nurses, and dialysis technicians all contributed to this team project. Eleven risk factors for low serum albumin levels were identified. All patients at Mercy Dialysis Center were assessed for each risk factor. Interventions were implemented to reduce these risks. Serum albumin levels were tracked at the beginning of our study, at ...Continue Reading

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