Dietary management of renal disease.
|Subject:||Kidney diseases (Diet therapy)|
|Publication:||Name: CANNT Journal Publisher: Canadian Association of Nephrology Nurses & Technologists Audience: Trade Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2008 Canadian Association of Nephrology Nurses & Technologists ISSN: 1498-5136|
|Issue:||Date: July-Sept, 2008 Source Volume: 18 Source Issue: 3|
|Product:||Product Code: 0101110 Calories; 2065357 Marshmallow NAICS Code: 31134 Nonchocolate Confectionery Manufacturing SIC Code: 2064 Candy & other confectionery products|
|Geographic:||Geographic Scope: United States Geographic Code: 1USA United States|
This article was first published in The Dialtec (1978), 1(3), pp.
In renal disease, it is vital that adequate amounts of calories are eaten each day. Adequate caloric intake is essential to prevent breakdown of protein for energy needs, resulting in weight loss. Generous use of allowed carbohydrates and fats is encouraged since the end products of their catabolism--carbon dioxide and water--do not impose a burden on the kidney.
Each patient's caloric needs are based on their height, weight, age, sex and activity. The prescribed diet should ensure an intake of 35 to 45 calories per kilogram of body weight.
Special calorie supplements may be needed to help increase the calorie content of the diet. The supplement most commonly used and acceptable to the patient is Gluconal. Gluconal is electrolyte free, colourless, tasteless and contains approximately 112 calories per ounce. It can be mixed with any beverage desired.
Other products that may be used to increase calories are Cal-Power and Hycal (both high-calorie beverages) and low-protein pasta and bread products. The low-protein bread and pastas are often difficult to obtain and are not too acceptable to the patient.
Some suggestions given to patients, to help increase the caloric content of their diets are as follows:
1. Use heavy cream (whipping) on cereal, in beverages, on fruit and desserts. It contains 96 calories per ounce.
2. Add extra sugar to fruit and fruit juices.
3. Use high-calorie desserts instead of always fruit.
4. Substitute suitable soft drinks or cranberry juice for coffee or tea.
5. Use cranberry sauce, apple jelly, mint jelly or red currant jelly as meat accompaniments.
6. Use as much salt-free butter as possible for vegetables, bread and cooking.
7. Use candies--hard clear types, jelly beans, gum drops, ju jubes, and marshmallows as snacks.
8. Use as much jam, jelly, and honey as possible on toast and bread.
Vitamins and minerals
The vitamin and mineral intake of patients on a restricted protein, potassium and sodium diet often does not meet the recommended daily allowances for certain vitamins and minerals. This is especially true for the water-soluble vitamins such as Vitamin C and the B vitamins, which are abundant in high-potassium foods such as fruits, vegetables, meat and milk. Also, there is a loss of water-soluble vitamins during dialysis treatments.
When the protein restriction is less than 50 grams per day, the diet tends to be low in folic acid, niacin, riboflavin, thiamine and vitamin B6.
Patients on long-term low-protein, low-sodium, low-potassium diets should receive a multivitamin capsule and folic acid daily to ensure adequate intake and to make up for losses that occur during the course of dialysis.
Interested in a new recipe for the summer?
YIELD: 1 cup (1 serving)
SUBSTITUTE: 1 serving for 1 fruit exchange
4 large or 20 small marshmallows
1/4 cup diced fruit (use only those fruits allowed on the diet)
1/4 cup whipping cream
1 tablespoon white sugar
1. Cut marshmallows into quarters or leave whole if using small marshmallows and combine with fruit. Chill in refrigerator for several hours.
2. Whip the cream. Fold in sugar.
3. Fold the sweetened whipped cream into fruit marshmallow mixture. Chill before serving.
Protein: 2 grams
Potassium: 2.2 mEq
By Mrs. J. Somers, PDt, Renal Dietitian, Victoria General Hospital, Halifax, NS
|Gale Copyright:||Copyright 2008 Gale, Cengage Learning. All rights reserved.|