Question

a.Imagine this situation. You are working in hospital. You got a new patient referral his name is Salim. You found that he has Crohn's disease, diabetes and chronic kidney disease (stage 4), which condition would you focus on for MNT and why?

Answer 1

For chronic kidney disease stage 4 condition i would focus on for MNT ( Medical nutritional therapy ) . MNT which is abbrevated form of medical nutritional therapy is an evidence based medical approach to treating certain chronic conditions through use of an individually tailored nutritional plan . Although in this case medical nutritional therapy for all the condition is required but if MNT for crohn's is managed which is not as chronic as CKD ( stage 4 ) can affect kidney as crohn's patiebt need diet rich in high fibre and protein but CKD patient need diet of low protein . Diabetes is commonly associated with chronic kidney disease , so in this case ckd should be focused for MTN Because its very chronic condition and need proper diet to avoid complication as its further complication can lead to death of patient and its controlling will eventually control diabetes . So required to focus on CKD (stage 4) for MTN by reducing protein consumption to help decrease build up of protein , consuming fruits grains and vegetables , less consumption of calcium , limiting phosphorous and potassium if above normal level in blood , lowering sodium consumption and cutting back carbohydrates for those with Diabetes. Thus MNT for chronic kidney disease will eventually prevent its complication also complication of diabetes. Not of crohn's to be done as in crohn's high fibre diet with high protein also carbohydrates rich diet is recommended to remove malnutrition but it can complicate condition of chronic kidney disease which is most important to be prevented from further complication in a patient.

So it is CKD with stage 4.

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