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Diet in Renal Disease - Coggle Diagram
Diet in Renal Disease
Nutrition
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potassium, phosphate, calcium, sodium, fluid
when patient becomes anuric, careful of salt intake as can make patient thirsty (500mls limit daily)
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Prior to starting dialysis, some evidence of limit on protein to stop progression of CKD (american guidelines lower but malnutrition is a risk so UK guidelines keep at 0.8-1g/kg/day)
Once dialysis started, keep 1.1-1.2g/kg/day and 30-40 kcals/kg/day and achieving normal body weight
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Function of kidneys
produces EPO- tells bone marrow to produce red blood cells so monitor for anaemia (pale colour, tired) / Hb levels
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excretion of water soluble drugs, hormones e.g. insulin
End stage renal failure
without form of renal replacement therapy, patient likely die (HD, PD, transplant). If no RRT, then conservative/ End of life care
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Peritoneal dialysis (PD): 24 hr treatment. Dialysate pumped into peritoneal cavity to extract excess water and salt/toxins. Dialysate is sgluocse mixture.
Diet and phosphate
high phosphate foods are usually high processed foods due to additives which are highly absorbed in comparison to animal and plant phosphate
Ideal phosphate binder e.g. calcium carbonate, calcium acetate, aluminium hydroxide (less so as ? toxic),
fluid output/ input
too much will increase BP, SOB, and swelling of ankles. Restrcit 500mls + previous days urine. around 6 months on dialysis patient may stop passing urine altogether
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eGFR - best estimate of kidney function. can calculate with age, gender and creatinine = mL/min/1.73m2
Biochemistry monitored- Na, K, Corr. Ca2+, po4-, albumin, bicarbonate
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