ABSTRACT
Introduction ............................................................................................................................................................................. 815 Nutritional Assessment in the Renal Patient ........................................................................................................................... 815 Stages of Renal Failure ........................................................................................................................................................... 816
Acute Renal Failure: Daily Nutrient and Fluid Needs ....................................................................................................... 817 Chronic Renal Failure: Daily Nutrient and Fluid Needs ................................................................................................... 818 Post Kidney Transplant: Daily Nutrient and Fluid Needs ................................................................................................. 818
Peritoneal Dialysis: Daily Nutrient and Fluid Needs .............................................................................................................. 819 Hemodialysis: Daily Nutrient and Fluid Needs ...................................................................................................................... 820 Special Nutrition Focus ........................................................................................................................................................... 820
Pregnant Hemodialysis Patients ......................................................................................................................................... 822 Adult Dialysis Patients with Diabetes Mellitus ................................................................................................................. 823 Dialysis Patients with Aids Nephropathy ........................................................................................................................... 823
Osteodystrophy Management in Chronic Kidney Disease ..................................................................................................... 824 Phosphate Binders .............................................................................................................................................................. 824
Phosphate Binders/Calcium-Based Supplements .......................................................................................................... 824 Phosphate Binders/Non-Calcium-Based Supplements ................................................................................................. 824
Vitamin and Mineral Supplements ..................................................................................................................................... 824 Enteral Nutrition Supplements for the Renal Patient .............................................................................................................. 825 Practical Application of the Diet ............................................................................................................................................. 828
Food Choices to Control Potassium and Phosphorus ........................................................................................................ 828 Suggested Meal Plans and Sample Menus ......................................................................................................................... 828 Emergency Shopping List .................................................................................................................................................. 829
Summary ................................................................................................................................................................................. 830 References ............................................................................................................................................................................... 831
The kidneys play a vital role in the maintenance of normal blood volume/pressure and the regulation of acid-base balance. Approximately one-fourth of the cardiac output is fi ltered through the kidneys each minute. Urinary excretion is the pathway for removal of the waste products of absorption and metabolism. These include ammonia, urea, creatinine, phosphorus, water, sodium, and potassium. Normal bone health is facilitated by activation of vitamin D and regulation of calcium and phosphorus. The kidney produces the hormone erythropoietin. Defi ciency of this hormone results in profound anemia.
