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Running head: DIET FOR MRS.

WILSONS CHRONIC RENAL INSUFFICIENCY

Diet for Mrs. Wilsons Chronic Renal Insufficiency


Nina Wilczynski
The University of South Florida College of Nursing

DIET FOR MRS. WILSONS CHRONIC RENAL INSUFFICIENCY

Mrs. Wilson is diagnosed with chronic renal insufficiency, borderline renal failure. She
has a dialysis consult set, indicating her kidneys are unable to filter excess fluids and wastes. Her
diet must change to accommodate this change in health. This new diet aims at balancing the
electrolytes, minerals and fluids in the body which the kidneys can no longer regulate
(MedlinePlus, 2013). Changes in diet include limiting fluid intake, decreasing protein intake
before dialysis and increasing protein intake after dialysis, and limiting salt, potassium,
phosphorus.
Increased fluid can accumulate in the lungs, leading to difficulty breathing (College of
Wisconsin, 2014). Since the kidneys no longer excrete excess fluid, it is important to limit fluid
intake. This means limiting fluids such as water, coffee, tea, alcohol and soda, yet also limiting
foods high in fluid such as gelatin, lettuce, grapes, melons, tomatoes and celery (MedlinePlus,
2013). To decrease fluid intake, drink only when thirsty, not out of habit or at social events.
Brush your teeth three to four times a day to prevent your mouth from drying out. When dining
out, ask for a beverage served in a child sized glass. Sucking on ice chips measured in small
amounts also helps to eliminate thirst (College of Wisconsin, 2014).
Before starting dialysis, protein intake should controlled to 0.8-1.0 g per kg of body ideal
body weight (ideal body weight is determined by a physician) (Sloan, Elliot, Reed, 2001) Since
the kidneys are no longer able to filter excess protein from the blood, excess protein can remain.
This excess protein can make the blood more acidic, increasing muscle breakdown and further
damaging the kidney (Sloan, Elliot, Reed, 2001). However, the excess proteins will be filtered
from the blood after dialysis. A person on dialysis should eat 8-10g of protein per day
(MedlinePlus, 2013). A doctor or dietician might suggest adding egg whites, egg white powder
or protein powder to the diet of someone on dialysis (MedlinePlus, 2013). Sources of protein

DIET FOR MRS. WILSONS CHRONIC RENAL INSUFFICIENCY

include beef and lamb, pork, chicken and turkey, seafood, eggs, milk products and protein
powders such as creatine (College of Wisconsin, 2014).
When on dialysis, a person still needs salt, phosphorous and potassium. However, since
the kidneys arent able to excrete extra amounts of these nutrients, they can often accumulate to
high levels in the blood stream. The risk for toxic levels of these nutrients often leads to limiting
them in the diet. Salt can increase fluid retention, which in turn can increase blood pressure
(Sloan, Elliot, Reed, 2001). Avoid adding salt to foods. Also, limit foods with a high salt content
such as bouillon cubes, canned vegetables, process and frozen meals, bacon, potato chips and
nuts (College of Wisconsin, 2014). Increased serum phosphorus causes the body to take calcium
from the bones and move it to the blood. This leaching of calcium causes the bones to become
very brittle (College of Wisconsin, 2014). On dialysis, one should eat foods low in phosphorous.
Foods high in phosphorous include dark colas, peanut butter and nuts, cheese, sardines, chicken
and beef liver, caramel and ice cream. Some low phosphorous alternatives include light sodas,
broccoli, sherbet, hard candy and zucchini squash (College of Wisconsin, 2014). Potassium is a
mineral that aids in nerve and muscle function. High levels of potassium can lead to cardiac
dysrhythmia and even cause the heart to stop (MedlinePlus, 2013). Foods high in potassium
include bananas, chocolate, cantaloupe, broccoli, bran, and raisins. Foods low in potassium
include apples, rice, noodles, cherries, cranberries and carrots (College of Wisconsin, 2014).
Thus, fluid retention, protein intake and salt, phosphorous and potassium intake are all
important aspects of a diet for Mrs. Wilson. This new diet focuses on balancing these three areas
carefully as the kidneys are no longer able to remove wastes and excess fluid from the body.
Mrs. Wilson should always make sure to create a diet specific to her needs with her physician or
a dietician.

DIET FOR MRS. WILSONS CHRONIC RENAL INSUFFICIENCY


References
College of Wisconsin. (2014). Division of Nephrology. Diet for Renal Patient. Retrieved from
http://www.mcw.edu/Nephrology/ClinicalServices/DietforRenalPatient.htm
MedlinePlus. (2013, Oct 2). In MedlinePlus Medical Encyclopedia. U.S National Library of
Medicine. Diet - chronic kidney disease Retrieved from
http://www.nlm.nih.gov/medlineplus/ency/article/002442.htm
Sloan E., Elliot H., Reed S., (2001, Jan). Edenburg Renal Unit: Diet for the Failing Kidney and
CKD. Retreived from http://www.edren.org/pages/edreninfo/diet-in-renal-disease/dietfor-the-failing-kidney-and-ckd.php