Nutrition Assessment (Clinical Application)
Case Study - Chronic Renal Failure
Subject: Mrs A, 60 year old female.
Social H: Ex-process worker, retired ~5 years ago. She lives with her husband, 1 cat and 1
dog. She has 2 daughters who live nearby. Smoking ceased 10 years ago. She usually leads
an active social life, enjoys shopping with friends and plays tennis twice a week.
Medical Diagnosis: Chronic Renal Failure for 15 years due to analgesic nephropathy
Recent Complaints:
 Increased lethargy, tiredness over last 3 months, unable to go out much and walk
the dog and does little housework.
 Taste aversion, nausea and doesn’t enjoy eating red meat
 Uncontrolled hypertension
Anthropometric and Biochemical information:
9 months ago
Creatinine (N 60 – 120 umol/l)
180
Urea (N 2 – 8 mmol/l)
20.2
Albumin (N 35 – 50 g/L)
40
Weight (kg)
50
MAC (cm)
30.4
TSF (mm)
25
Height – 156 cm
Today
420
26.6
35
49.5
28.6
24.5
Diet History:
Appetite and intake were good up to 5-6 months ago. Recent intake on a typical day for last
3-4 months is indicated as below:
Breakfast
 Small bowl of cornflakes
with 1 tsp sugar and 100
ml FC milk
 100 ml orange juice
 1 cup tea with milk and 1
tsp sugar
Lunch
 1 slice of white bread,
with margarine and jam
 1 small banana
 1 cup tea with milk and 1
tsp sugar
Am
Water ~ 2 glasses
Pm
Cup of tea, 1 biscuit
occasionally
Dinner
 2 fish fingers or 1
chicken drumstick –
grilled
 1 small potato, mashed
and 2 other vegs, e.g.
beans, carrots
 1 tab ice cream and jelly
Supper
3x/week, 1 small glass of
milk (100ml)
Other Information:
 Uses little salt or salty food
 May miss lunch or dinner 3-4 times / week due to poor appetite
 Alcohol – nil
Tutorial Activity
Comment on Mrs A’s Case using the ABCDE format. For D (diet) – just qualitative comments
only. No calculations required for the purpose of this tutorial. What is your overall
assessment of Mr A’s nutritional status.