Chronic Kidney Disease Flashcards
Definition
NICE 2014
Abnormalities of kidney functions/structure >3m with implications for health
Classification
1-5
By GFR rate 1 = >90 2= 60-89 3= 30-59 4= 15-29 5= <15
Stage 1-3
Management to slow progression
Reduce CVD risk Regular exercise Smoking cessation Limit alcohol intake Lipid lowering advice Healthy weight (BMI 20-25) Control hypertension + diabetes
Stage 1-3
Interventions
ACE inhibitors
Use of statins
Decrease dietary salt
DASH diet - may increase K + Ph
Stage 4/5 management
Reduce CVD risk
Education on condition + RRT
Reviews of eGFR + minerals
Protein
0.8-1g/kg IBW/day
Protein
Restriction
0.6g/kg IBW/day 70% should be high biological protein Help alleviate uraemic symptoms Malnutrition risk Meal plan + exchanges list
Protein
Restriction - exchanges
6g -> 25g meat/ 1 egg/ 200ml milk
2g -> 25g bread/ 50g chips/ 75g rice
E.g. 42g
5x6g and 6x2g (70:30)
ONS
Mindful of sodium, potassium, phosphate levels
Potassium
Foods
Banana Dried fruit Chocolate Tomatoes Potato Spinach
Potassium
Restriction
1mmol/kg/day
Only when serum levels high
Portion size
Limit high K food sources
4mmol exchange list
Potassium
Restriction - exchanges
4mmol
50g cherry tomatoes
100g peas
125g carrots (boiled)
1 medium apple
Phosphate
Monitor blood levels
Limit if serum levels high (will also limit protein)
Establish intake from diet history then reduce + replace sources
Additives
Phosphate binders
Bind to phosphate + remove
Calcichew
Alu-cap
Sodium
Foods
Marmite Convenience foods Packet soups + sauces Cured meat Stock cubes Cheese biscuits
