C8 Renal Disorders

Question 1

Differentiate between the two types of glomerular diseases.

Answer 1

Nephritic syndrome:
A sudden inflammation of capillary loops of glomerulus which may recover or develop into nephrotic syndrome or ESRD. Causes hematuria

Nephrotic syndrome:
Loss of glomerular barrier to protein, causing excessive proteinuria. The body then lose proteins needed to maintain fluid balance.

Question 2

Describe the protein, energy and sodium intake for a patient suffering from nephrotic syndrome.

Answer 2

• Protein: Restricted to 0.8g/kg
• Energy: 35kcal/kg (adults); 100-150kcals/kg (children)
• Sodium: Restricted to 3g sodium daily

Question 3

Describe acute renal failure and nutritional therapy.

Answer 3

• Sudden reduction in glomerular filtration rate and impaired ability of kidney to excrete metabolic waste
• Protein (0.5-0.9g/kg; 1-2g/kg for dialysis)
• Energy 30-35 kcals/kg
• Sodium 1.5-3g/day

Question 4

How is ESRD treated?

Answer 4

• Transplantation
• Dialysis
• Medications

Question 5

Describe nutritional therapy for patient on dialysis.

Answer 5

• Protein: 1.2g/kg/day with 50% high-quality protein
• Sodium: Reduce salt and liquid intake if high fluid gains
• Potassium: Monitor and adjust accordingly.

Question 6

Describe the nutrient intake for a patient that underwent kidney transplantation.

Answer 6

• Protein: 1.3-1.5g/kg, 1.6-2.0 if needs increases
• Energy: 30-35 kcal
• Restrict sodium