Chronic Renal Failure
LUIS ANGEL ZAPATA
MARCDALA ANTOINE
JOSIE CAPELLAN
Case scenario
J.M. is a 55 years old male from Miami Florida. He was admitted to the
Hospital with generalized body weakness and fatigue for
Over 2 weeks.
He has a history of high blood pressure and patient also has
History of pedal edema for the past 2 months.
But no history of breathlessness
On examination, patient vitals signs are stable , crackles
Is present ,he is alert and cooperative.
The results of the blood work shows RBC is low,
High protein in urine sample .
GFR of 30 to 59 mL/min/1.73m2
Pathophysiology of Chronic Renal Failure:
The kidneys act as regulator for many body’s function and control
complex process that maintain homeostasis.
Each kidney has approximately 1 million nephrons, providing a large
reserve of nephrons
However, when 90% of nephrons are lost, renal function is
significantly
Impaired.
[Link]
transplant/bdbdcdj5?q=++kidney&FROM=LKV
R5>1=LKVR5&FORM=LKVR8
[Link]
physiology/bd979s45?q=++kidney
HEALTH TEACHINGS FOR PATIENT
FACTS
Stage 3 in Chronic Kidney Disease is considered a pre-dialysis
stage.
A variety of foods can be eaten that include a prescribed amount of
high quality protein, carbohydrates and fats with adequate caloric
intake.
Sticking to a meal plan recommended by the renal dietician will
help reduce excess buildup of wastes and fluid.
Source: [Link]
diet/a/490
BENEFITS OF FOLLOWING DIET
If followed strictly it can delay the progression of kidney disease
which at worst is ESRD (stg. 5) which requires dialysis and/or
transplant.
Important to understand that diet is therapeutic to the condition
and not a cure nor a reversal to the damage already experienced
to the kidneys.
Lab results will be indicative of diet’s effectiveness Particularly
the creatinine level because it measures GFR which shows how
effectively the kidneys are filtering waste and excess fluid from
the bloodstream.
Source: [Link]
BENEFITS OF DIET CONTINUED…
Help manage blood glucose and blood pressure levels to prevent
development of diabetes and hypertension.
Preserves current kidney function.
Source: [Link]
WHAT ABOUT FLUID INTAKE?
Normal fluid intake (stg. 3) can be tolerated but swelling may
still occur (due to retention).
This may be because of high sodium intake or decreased
function of kidneys.
The doctor and dietician will work to monitor this and make
modifications in diet and medications to assist with the
swelling.
Source: [Link]
diet/a/490
LIFESTYLE FACTORS
Saturated fat and salt intake should be reduced in
order to reduce blood pressure.
Smoking (cessation)
Weight management
Exercise
Restrict alcohol consumption
Source: [Link]
nutrition/diet-basics/the-ckd-non-dialysis-
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
It is recommmened that patient limit their intake of fluids b/c the kidneys are less able
to remove fluids from the [Link] fluid can cause a build up in the lungs,
hands and feet (edema)
An unhealthy kidney is able to remove excess sodium from the body but b/c our
patient suffers from hypertension and edema which can be cause by to much
sodium. Patient is also put on a low soduim diet.
It is very important that we also put the patient on a low protein diet to limit the
amout of waste product in the blood and phosphorus must be restricted from the
diet.
Avoid foods high in phosphorus, potassium, Sodium, and protein!
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
Day 1
Breakfast
1 cup of coffee
Non dairy creamers ( lower phosphorus compared to other dairy products)
1 english muffin
Lunch
Sea food salad ( made with imiation crab meat, lower protein compared to tuna)
Lemon lime soda ( lower phosphorus compared to cola)
A 3- ounce serving of meat is about the size of a deck of cards or the plam of you
hands. You can watch your protein intake by limiting meat in your diet to two 3
ounce servings each day.
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
Dinner
Chicken drumstick ( cooked in olive oil which is a good fat)
Plain rice ( lower sodium compared to packaged rice with sauce)
Apple juice ( low in potassium)
Day 2
Breakfast
Decaf tea
Low cholesterol eggs ( cholesterol can clog pores and increase patients risk for
heart disease.
Cream of wheat
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
Lunch
Cottage cheese canned fruit plate ( canned fruit is lower in potassium)
Cranberry juice
Dinner
Salisbury steak with green beans
Sherbet
Root beer
Green beans,Sherbet, and Root beer are low in phosphorus
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
Day 3
Breakfast
Whole grain pancakes ( using whole wheat flour, use egg whites to lower total
amount of protein)
4oz skim milk
Lunch
Turkey sandwich ( use only one or two slices to lower protein intake, no
tomatoes, you can add a bit of meyo and lettuce)
Unsweeted Iced tea ( sugar or sugar substiute depending on if patient is diabetic)
CHRONIC RENAL DISEASE
THREE DAY MEAL PLAN
Dinner
Chicken casserole with broccoli
Diet pound cake
Lemonade ( powered mix)
Snacks
Peaches, fresh apple or pear, jam doughnut, unsalted crackers, hard candy, diet
jello, diet pound cake and etc...
Renal diet vary among individuals depending on the nature, severity, and stage of the
disease.
Reduce protein intake by 0.2 grams for kilogram of body weight. Aim to keep sodium
intake less than 1,500 milligrams
