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Introduction to Renal Nutrition


.

When the kidney is not functioning:

  • Waste products from digested foods build up in the blood (uremia).
  • These waste products are poisonous to the body.
  • The wastes come from foods containing protein, sodium, potassium, phosphorus, and fluids.

The kidney’s jobs are:

  • To remove protein waste products from the blood.
  • To remove excess water from the body.
  • To maintain the proper chemical and water balance by removing excess minerals and fluid from the body.
  • To manufacture vital hormones
Renal: concerning the kidneys.

 

Because your kidneys are not functioning properly, you may be feeling some uncomfortable side effects such as a general ill feeling, loss of your appetite, nausea, and high blood pressure. Dialysis removes waste products from the body and helps decrease these side effects. Remember that dialysis is not as efficient as normal kidneys and the waste products build up between each treatment. For this reason, dialysis patients need to follow a special diet.

The dietitian will work with you and your family to develop a diet that meets your food preferences and your lifestyle as much as possible. Your diet plan may change periodically as your condition or type of dialysis changes. Your dietitian will keep you informed of any changes needed in your diet.

Dialysis: the process of removing wastes and maintaining the chemical balance of blood when the kidneys no longer function.

Your Special Diet

  • Helps control waste products in the blood by limiting foods high in sodium, potassium, and phosphorus. It also regulates protein foods and fluids.
  • Helps you reach and maintain your dry weight.
  • Ensures that you receive adequate nutrition with the aid of vitamin supplements
REMEMBER! Your diet is as important as the medicine and the treatments prescribed by your doctor. It does affect your medical progress.
Hemodialysis: the type of dialysis that removes excess body wastes and fluids from the blood as it passes through an artificial kidney.

Types of Diet Therapy

Decreased Kidney Function

When it is first discovered that your kidneys are not functioning as they should, your doctor may prescribe a diet low in protein to slow down the progression of kidney disease. Your intake of phosphorus, sodium, and potassium may also be reduced. Your dietitian will help you and your family make the necessary changes in your diet.

Dry weight: the body’s true weight, without excess fluid.

Hemodialysis

Your blood is cleaned three times a week with this type of dialysis. Because waste products, toxins, and fluid build up between dialysis treatments, it may be important for you to be more cautious with food and fluids. If your urine output is low you will need to limit fluids and salt intake. Minerals like potassium and phosphorus now need to be monitored. In most cases you will need to eat more protein than was allowed prior to receiving dialysis treatments. You will also need to eat enough calories to keep from losing "dry weight" unless otherwise planned with the dietitian.

The diet order for hemodialysis patients generally reads:
80 grams protein (may vary), 2000-3000 mg sodium, 2000 mg potassium, 1500 cc (6 cups) fluid

Rules for Eating During Your Dialysis Treatment if Permitted

  • Remember that it takes time for food to digest. Waste products from what you eat at this time will not be cleaned from your blood until your next treatment.
  • Fluid restrictions still need to be considered. Drinking too much fluid during dialysis makes it difficult to achieve your dry weight.
  • Therefore, don’t ignore your diet while you dialyze!

Peritoneal dialysis: a form of dialysis that uses the lining of the patient’s abdominal cavity, the peritoneum, for dialysis

Dialysate: the solution used during dialysis to pull waste products out of the blood.

Peritoneal Dialysis

You will be making "daily" exchanges with this method of dialysis, which allows for a more constant removal of waste products and toxins – most nearly like your own kidneys. Consequently, your diet will include more sodium, potassium and fluid than before. Protein "leaks out" in this process, though, and you will be instructed to increase your protein intake to replace what you lose. With peritoneal dialysis, your body also absorbs sugar from the dialysate, which may cause weight gain or may affect blood sugar for people with diabetes.

The diet order for peritoneal dialysis patients generally reads:

100 grams protein (may vary), 4000 mg sodium, 4000 mg potassium, 2000 cc (8 cups) fluid

Kidney Transplantation

Weight loss may be necessary before your transplant surgery. After a successful transplant, it is still important to watch your diet. Your food choices should balance the effects of the medications that must be taken to avoid rejecting the transplanted kidney. You will discuss weight and cholesterol control with your dietitian. Salt restriction is often still needed.

Your doctor and dietitian have created a meal plan specifically for you in your current health status. Keep in mind that your diet may change as your blood tests are evaluated.

General Guidelines for Your Personalized Meal Plan

The foods on this plan are divided into six groups according to the amount of calories, protein, potassium, and phosphorus they contain: meat and other high protein foods, milk, starches, vegetables, fruits, and fats. These food groups are also called exchange lists because foods within the same group may be exchanged or traded for one another to build your daily meals. Choose foods from the different lists to meet your personal dietary needs and to add variety to your diet.

Exchange lists: foods put into groups based on their nutritional content.

Helpful Hints for Success

  • Follow your daily food plan and meal pattern when selecting your meals for the day. Be certain to include all the foods allowed daily to meet your nutritional needs.
  • Use only the foods listed on your meal plan in the amounts shown. Do not add new foods without the advice of your doctor or dietitian.
  • Measure foods accurately. Obtain a food scale, a set of measuring spoons, and a set of measuring cups, both dry and liquid measure.
  • Be sure to contact the dietitian if you need help with your diet.
  • Read all labels carefully before buying and avoid purchasing food containing salt, sodium compounds, or salt substitute (potassium chloride).
  • Do not use a "salt substitute" because it contains potassium.
  • Do not use salt during food preparation or at the table.
Average Nutrient Content per Exchange or Serving

Group

Calories

Protein

(gm)

Potassium

(mg)

Phosphorus

(mg)

Sodium

(mg)

Meat and Other High Protein Foods

75

7

80

85

80

Milk

80

4

175

120

95

Starches

80

2

65

45

100

Vegetables

25

1

  1. 100
  2. 200
  3. 300

20

10

Fruits

60

0.5

  1. 100
  2. 200
  3. 300

20

10

Fats

45

0

7

10

50

Potassium

 



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