NS 254 Elimination Reading Notes.docx - NS 254 Elimination...

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NS 254 Elimination Reading Notes 1. Identify dietary restrictions for patients with chronic kidney disease/failure. a. Protein restriction 1. Stages 1-4: 1. Normal protein intake 2. Peritoneal Dialysis: 1. 1.2 – 1.3 g/kg/day 3. Hemodialysis: 1. 1.2 g/kg/day 4. Pre-ESRD: 1. Individualized or 0.6 – 1.0 g/kg/day (low protein) b. Fluid Restriction 1. Stages 1-5: 1. Not routinely restricted 2. Pre-ESRD: 1. As desired or depends on urine output 3. HD: 1. Urine output plus 600-1000 mL 4. PD: 1. Unrestricted if weight and BP controlled and residual renal function c. Sodium Restriction 1. Pre-ESRD: 1. Individualized or 1 – 3 g/day 2. HD: 1. Individualized or 2 – 3 g/day 3. PD: 1. Individualized or 2 – 4 g/day 4. Avoid high sodium foods such as cured meats, pickled foods, canned soups and stews, frankfurters, cold cuts, soy cause, and salad dressings d. Potassium Restriction 1. Pre-ESRD: 1. Individualized based on lab values 2. HD: 1. Individualized or about 2 – 4 g/day 3. PD: 1. Usually not restricted 4. Avoid salt substitutes 5. Foods High in K+ to AVOID: 1. Fruits:
1. Apricot, raw (medium) 2. Avocado (1/4 whole) 3. Banana (1/4 whole) 4. Cantaloupe 5. Dried fruits 6. Grapefruit juice 7. Honeydew 8. Orange (medium) 9. Orange juice 10. Prunes 11. Raisins 2. Vegetables: 1. Baked beans 2. Butternut squash 3. Refried beans 4. Black beans 5. Broccoli, cooked 6. Carrots, raw 7. Greens, except kale 8. Mushrooms, canned 9. Potatoes, white and sweet 10. Spinach, cooked 11. Tomatoes or tomato products 12. Vegetable juices 3. Other: 1. Bran or bran products 2. Chocolate (1.5 – 2 oz) 3. Granola 4. Milk, all types (1 cup) 5. Nutritional supplements (use only under the direction of physician or dietitian) 6. Nuts and seeds (1 oz) 7. Peanut butter (2 Tbsp) 8. Salt substitutes, lite salt 9. Salt-free broth 10. Yogurt e. Phosphate Restriction: 1. Pre-ESRD: 1. Individualized or 1.0 – 1.8 g/day 2. HD: 1. Individualized or about 0.6 – 1.2 g/day 3. PD: 1. Individualized or about 0.6 – 1.2 g/day

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