Renal Disease Flashcards
role of the kidney
- regulation of fluids and electrolytes
- clearance of nitrogenous waste
- maintenance of acid base balance
- production of hormones
CKD disease has how many stages that are marked by reduction of what
- 5
- GFR
what happens in the last stage of CKD and how is it treated
- renal failure
- renal replacement therapy
RRT includes what
- hemodialysis
- peritoneal dialysis
- continuous RRT
almost half of all renal failure is caused by
-diabetes mellitus
goals of nutritional intervention in kidney disease
- preservation of renal function
- assist incontrol of uremic symptoms
- nutrtional adequacy and lean body mass
causes of malnutrtion in renal patients
- unpalatable diets
- delayed gastric emptying
- inflammation and infection
- multiple meds
- metabolic acidosis
- social factors: loneliness, depression, poverty
a technique to slow GFR decline and maintain nutritional status
-a protein controlled diet of 0.6-0.8 grams per kiogram is recommended for CKD patients not on dialysis
how do we address sodium and fluid dysregulation
- restrict diet to 1-3 grams of sodium daily
- possible fluid restriction
managements of hyophosphatemia
-restricted phospohorus diet and dietary phosphorus binders
what manifests into secondary hyperthyroidism in renal patients and why
- vitamin D deficiency
- liver can not hydroxylate vitamin D into its active form so it does not cause Ca absorption which would inhibit PTH release
- however, without its inhibition, PTH is released and causes an increase in Ca resorption from bone
providing supplemental active vitamin D prevents
- secondary hyperparathyroidism
- excess bone resorption
what hormone can the kidney not produce during failure
- EPO
- causes anemia
what can lead to protein breakdown in patients with kidney failure
- metabolic acidosis
- this is due to loss of normal acid secretion
- treated with the administration of bicarbinate to maintain balance
what is the most common therapy for renal failure
-dialysis
hemodialysis can have what nutritional effects?
- appetite changes
- nausea
- vomiting
- fatigue
- constipation
- protein loss
what nutritional factors are recommended in patients on hemodialysis?
- additional protein consumption (at least 1.2g/kg)
- fiber intake in the range of 25-30 g/day
- reduced sodium, potassium, phosphorus, and fluid
what can peritoneal dialysis provide
- what is recommended for these patients
- what are some common side effects/ problems
- a significant glucose load via the dialysate
- increased satiety effect from the dialysate
- higher risk for peritonitis
nutrtional assessment of renal patients
-biochemical measures
- monitoring dietary intake
- dry weight trends
- skinfold and muscle circumference
- biochemical measure such as: albumin, blood urea nitrogen, creatine, potassium, and phosphorus
