mnt II final Flashcards
(36 cards)
CKD diet
- limit sodium to 2300 mg
- restrict protein to 0.6-0.8 g/kg/d
- restrict P and K if labs are elevated
CKD complications
DM and HTN can lead to CKD development hyperkalemia, anemia, PEW associated/prevalent
phosphorus sources
cheese, milk, ice cream, beef liver, oysters, organ meats, sardines, beans/peas/lentils, caramels, bran cereals, nuts, ale, beer, colas, processed foods, white bread, deli ham/bacon, syrup, egg
PEW in CKD
protein energy wasting, a state of decreased body stores of protein and energy fuels. Common in CKD.
protein loss in hemodialysis
decreased synthesis: decreased intake (ana/dietary restrictions), inflammation, acidemia, insulin resistance, increased glucagon sensitivity and parathyroid hormone
increased catabolism/losses: renal losses (proteinuria), GI losses, dialysis losses, comorbid illness
protein and energy needs for CKD
excessive protein should be avoided, but adequate is needed. adequate calories to spare protein.
insulin and potassium
insulin deficiency may lead to hyperkalemia. Treat hyperglycemia with adequate insulin. K follows glucose into the cells
vitamin D and CKD
recommend supplementation if low, prevention of mineral and bone disorders
kidney stones
intake of 3L water per day
calcium oxalate stone prevention
calcium intake to DRI with meals. avoid vitamin C. low oxalate, avoid rhubarb, spinach, beets, almonds. avoid excessive protein intake, esp animal. limit sodium
uric acid stone prevention
limit high purine foods: animal meet. avoid excessive protein. limit alcohol
BMI
kg/m^2
obese = over 30
HTN nutrition diagnoses
excessive energy/sodium, overweight/obesity, knowledge deficit, physical inactivity
HTN recc
low sodium, DASH diet
high sodium foods
smoked/processed/cured meats and fish, canned soups and vegetables, salted snack foods, condiments, pickles, olives, prepared packaged and frozen foods, sauerkraut, cheese
DM nutrition therapy
carb counting
carb counting
- Consistent carb intake to manage blood glucose
- Divide total daily carbs into carb choices for meals and snacks
- 2000 kcal with 55% carb and 4 kcal/g carbs = 275 g carb = 18 carb choices/day
- 1 carb choice = 15 g carbs
- 2-4 choices for meals, 1 for snacks
high K foods
OJ, milk, potato chips, bananas, bran cereal, tomato, canned spinach, kiwi, apricot, syrup
risk of elevated P
depositied into soft tissue = calcification = increased risk of heart disease
risk of high K
K impacts body’s electrical system = heart concerns
patient with CKD may be on fluid and Na restriction bc of
edema
MNT goal of CKD
delay progression and prevent comorbidities
nutrition therapy for a patient with stage 2 CKD
managing DM or HTN if present
a challenge with dietary P management in CKD
high Ca intakes prevent P absorbtion, but XXX
