Haemodialysis

Question 1

Definition

Answer 1

Blood filtered through machine
AV fistula created
3x per week

Question 2

Protein

Answer 2

Req increased
1.1g/kg

Tips

• plan + cook ahead
• good source at every meal
• consider ONS (if inadequate)

Question 3

Energy

Answer 3

EE not increased
30-35kcal
Oral intake may decrease (dialysis)
Food diary days - dialysis, non-dialysis + weekend (min)

Question 4

Sodium + fluid

Answer 4

Limit for most
500-1000mL + PDUO
Aim to reduce intradialytic weight gain
Aim to keep weight gain between sessions <4% actual BW

Fluid gain - hypertension, SOB, swollen ankles

Question 5

Potassium
Limit….
Tips…
Non-dietary causes…

Answer 5

Limit intake if high serum - 1mmol/kg/d

Tips - plan ahead/ boil veg/ remove veg water

Non-dietary causes - constipation, blood transfusion, dehydration, inadequate dialysis, ACE inhibitors

Question 6

Phosphate

Answer 6

<1000mg/d
Phosphate binders + how to use

Tips - timing binder/ limit high sources/ review portion sizes/ diet history to establish sources

Question 7

IDPN

Answer 7

Intradialytic parenteral nutrition
For selected pt only

Infusion glucose, lipids, AAs run during dialysis session