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    Renal Patient Diet

    Uploaded by

    Kailash Nagar
    This document provides dietary guidelines for patients with renal disease undergoing hemodialysis. It notes that 40-70% of end-stage renal disease patients are malnourished. The renal diet aims to minimize waste buildup and fluid between treatments to improve nutrition and muscle mass retention. Key aspects of the diet include monitoring BMI and interdialytic weight gain, restricting sodium and fluid intake, and obtaining adequate calories and nutrients within those restrictions. Specific guidelines for sodium, fluid, calorie, and thirst management are presented.

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    Renal Patient Diet

    Uploaded by

    Kailash Nagar
    303 views16 pages
    This document provides dietary guidelines for patients with renal disease undergoing hemodialysis. It notes that 40-70% of end-stage renal disease patients are malnourished. The renal diet aims to minimize waste buildup and fluid between treatments to improve nutrition and muscle mass retention. Key aspects of the diet include monitoring BMI and interdialytic weight gain, restricting sodium and fluid intake, and obtaining adequate calories and nutrients within those restrictions. Specific guidelines for sodium, fluid, calorie, and thirst management are presented.

    Original Description:

    COMMUNITYHEALTHNURSING For B.Sc. Nursing and DIPLOMAINGENERALNURSING &MIDWIFERY By Kailash Nagar

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    This document provides dietary guidelines for patients with renal disease undergoing hemodialysis. It notes that 40-70% of end-stage renal disease patients are malnourished. The renal diet aims to minimize waste buildup and fluid between treatments to improve nutrition and muscle mass retention. Key aspects of the diet include monitoring BMI and interdialytic weight gain, restricting sodium and fluid intake, and obtaining adequate calories and nutrients within those restrictions. Specific guidelines for sodium, fluid, calorie, and thirst management are presented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    303 views16 pages

    Renal Patient Diet

    Uploaded by

    Kailash Nagar
    This document provides dietary guidelines for patients with renal disease undergoing hemodialysis. It notes that 40-70% of end-stage renal disease patients are malnourished. The renal diet aims to minimize waste buildup and fluid between treatments to improve nutrition and muscle mass retention. Key aspects of the diet include monitoring BMI and interdialytic weight gain, restricting sodium and fluid intake, and obtaining adequate calories and nutrients within those restrictions. Specific guidelines for sodium, fluid, calorie, and thirst management are presented.

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    of 16

    DINSHA PATEL COLLEGE OF NURSING

    COURSE NAME : DIPLOMA IN GENERAL NURSING &


    MIDWIFERY
    ACADEMIC YEAR : FIRST YEAR
    SUBJECT NAME : COMMUNITY HEALTH NURSING
    (NUTRITION)
    UNIT : 5th
    TUTORIL TITLE : RENAL PATIENT DIET

    Prepared by :
    Mr. Kailash Nagar
    Assistant Professor
    CKD H D
     Clinical studies have shown that renal patients may
    have inadequate dietary intakes during early stages

     40 - 70 % of patients with end-stage renal disease are


    malnourished

     Protein–energy malnutrition should be avoided in


    maintenance hemodialysis because of poor patient
    outcome (Evidence III).

     Towtypes of malnutrition I & II has been described


    in C K D patients
    (ESPEN 2008)
    Renal diet minimizes the amount of wastes

    A good meal plan choices can:


     Minimize build-up of waste products&
    fluid between treatments
     Improve nutritional and functional status
     Conserve muscle mass
    How can we monitor and Follow-up
    nutritional status?

    BMI = Weight (kg) / (height [m]2)

    Severely underweight Less than 16.0


    Underweight From 16.0 to 18.5
    Normal From 18.5 to 24.9
    Overweight From 25 to 29.9
    Obese Class I From 30 to 34.9
    Obese Class II From 35 to 39.9
    Obese Class III Over 40

    Haemodialysis patients should maintain a BMI >23.0


    Ideal Body Weight (IBW)
    For men = [ (height(cm) – 152.4) x 0.91) ] + 50

    For women= [ (height(cm) – 152.4) x 0.91) ] + 45.5

    If Actual B W > 30% I B W


    use

    Adjusted Body Weight (ABW)


    For men:Adjusted weight = [( actual weight- IB weight) x 0.38] + IB weight

    For women:Adjusted wt = [(actual weight- IB weight) x 0.32 ] + IB weight


    Interdialytic W eight Gain (ID W G )
     General recommendation +2 kg

     >5% fluid gains


     Excessive fluid intake

     Weight gain

     <2% fluid gain


     Inadequate fluid and/or food intake

     Weight Loss/Decreased body mass


    Calories
    Adequate energy intake essential to optimize nutritional
    status
    ⚫ Present in (Carbohydrates – Fats - Protein)

    ⚫ Calculated based on your


    ⚫current weight,
    ⚫weight loss goals
    ⚫age and gender
    ⚫physical activity and metabolic stress
    35 kcal/kg/d < 60 yrs
    30–35 kcal/kg/d ≥ 60 yrs

    Regular physical activity should be encouraged, and energyintake should be


    increased according to the level of physical activity (Opinion).
    To increase the energy content of meals:

     Add extra oil to rice,noodles,breads,crackers,and


    cooked vegetables.
     Add extra salad dressing.
     N on-protein calorie (N P C ) supplement can be added

    (J Ren Nutr. Nov. 2012 )


    Sodium
    Serum Sodium (nl 133-145 mEq/L)

    ⚫ Plays vital role in regulation of fluid balance and blood


    pressure

    In CKD& HD:-
    ⚫ May result in :-
     high blood pressure,
     fluid retention/swelling (edema)
     lead to shortness of breath
     Excessive thirst
     CHF
    Sources of D ietary Sodium
    Cook at home with low-sodium ingredients
    1,000- 4,000mg/d

    Cut out: • Salt for


    • High-sodium condiments
    • Processed, cured foods CKD&HD
    patient
    Add: • Herbs • Lemon
    • Spices • Vinegar diets

    Eat out less (especially Fast Food)

    Read labels

    No Added Salt (NAS)


    Fluids
    “any food that is liquid at room temp”
    Soup, gelatin, ice cream, ect.
    HD
    ⚫Urine Output + 1000 ml
    ⚫Limit IDWG (2-5% Estimated Dry weight )

    ⚫Excess fluid buildup ⚫Fluid restriction estimations


    are based upon:-
     Edema,HTN,CHF and
     Urinary output
    Breathlessness
     Disease state
     D elays wound healing  Treatment modality (dialysis,etc.)
    Tips for thirst and fluid control!

    Keep your mouth wet


    ⚫ Track your fluids ◦ Keep your mouth clean
    🞄toothpaste for dry mouth (biotene)
    ⚫ Avoid chewing lots of ice
    ◦ Rinse your mouth with cold water, but
    ⚫ Avoid refills at restaurant
    don’t swallow it
    ⚫ Avoid super-sized beverages
    ⚫ Limit salty foods
    ◦ Rinse your mouth with chilled
    ⚫ Small glasses at meals & meds
    mouthwash
    ⚫ Add lemon or Lime juice to water

    ◦ Chew on gum: Quench gum


    ⚫ Hot weather, temperature
    ⚫Keep your skin cool: cold wash ◦ Try lemon wedges or freeze grapes &
    cloth, mist-bottle strawberries
    ⚫Keep your lips moist with a chap
    stick
    If diabetic, control blood sugars

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