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Protein–Energy Malnutrition

Kathleen Barry, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Insufficient energy and/or protein to meet metabolic demands, leading to impairment in normal physiologic processes.

  • Commonly seen in children in resource-limited countries; estimated...

DIAGNOSIS

HISTORY

  • Diagnostic historical criteria for malnutrition:

    • Inadequate nutrient intake, based on estimated energy needs versus measured energy consumed

    • Weight loss (measured as amount or percentag...

TREATMENT

GENERAL MEASURES

  • Slowly restore and maintain fluid and electrolyte balance.

  • Initiate oral iron and folate supplements (begin iron therapy ~2 weeks after initiation of dietary treatment to avoi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Frequent assessment until weight stabilized (BMI >18.5 kg/m2)

  • Frequent electrolyte monitoring (including phosphorous and magnesium) to evaluat...

REFERENCES

1
Dwyer JT, Gahche JJ, Weiler M, et al. Screening community-living older adults for protein energy malnutrition and frailty: update and next steps. J Community Health. 2020;45(3):640–660.
2
...

CODES

ICD10

  • E46 Unspecified protein-calorie malnutrition

  • E41 Nutritional marasmus

  • E40 Kwashiorkor

  • E61.8 Deficiency of other specified nutrient elements

  • E42 Marasmic kwashiorkor

  • E44.0 Moderate protein-calori...

CLINICAL PEARLS

  • Malnutrition is a major contributor to preventable deaths worldwide, especially in children

  • Attention to slow feeding and frequent electrolyte monitoring will prevent re-feeding syndrom...

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