this is a consensus document from queensland health dietitians/nutritionists. developed: jan 2009...

This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: JThis is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 2011. Disclaimer: http:/www.health.qld.gov.au/masters/copyright.asp UNDER REVIEWan 2011. Disclaimer: http:/www.health.qld.gov.au/masters/copyright.asp UNDER REVIEW

Eating Well with Eating Well with Chronic Kidney DiseaseChronic Kidney Disease

Pre-dialysis EducationPre-dialysis Education

Queensland Health NEMO Renal Queensland Health NEMO Renal GroupGroup

This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review:This is a consensus document from Queensland Health Dietitians/Nutritionists. Developed: Jan 2009 Review: Jan 2011. Disclaimer: http:/www.health.qld.gov.au/masters/copyright.asp UNDER REVIEW Jan 2011. Disclaimer: http:/www.health.qld.gov.au/masters/copyright.asp UNDER REVIEW

Why Nutrition?Why Nutrition?

To keep healthy and well nourished.To keep healthy and well nourished.

To prevent build-up of unwanted To prevent build-up of unwanted nutrients and waste products.nutrients and waste products.

To help help slow the progression of To help help slow the progression of kidney disease.kidney disease.


Keeping Healthy is Keeping Healthy is important!important!

You need to be in tip top shape!You need to be in tip top shape!

Why?Why?

Well nourished people do better.Well nourished people do better.– Less chance of problems with dialysis.Less chance of problems with dialysis.– Improved ability to fight infection.Improved ability to fight infection.- Less time in hospital.Less time in hospital.- You feel better.You feel better.


How’s your nutrition?How’s your nutrition?

Ask yourself a few simple Ask yourself a few simple questions.questions.

– How is your appetite?How is your appetite?– Have you gone off protein foods?Have you gone off protein foods?– Have you lost weight without trying?Have you lost weight without trying?– Are you in your healthy weight range?Are you in your healthy weight range?


Your Healthy Weight Your Healthy Weight RangeRange

BMI(body mass index) = weight(kg)/Ht x Ht(m)


If you are underweight…If you are underweight…

Eat small meals regularly. Eat small meals regularly.

Make every mouthful count…Make every mouthful count…– Choose nutritious foods that are Choose nutritious foods that are

energy dense.energy dense.– Make sure your drinks are Make sure your drinks are

nutritious.nutritious.

See a Dietitian.See a Dietitian.


If you are overweight…If you are overweight…

Your kidneys work harder if you Your kidneys work harder if you are overweight.are overweight.

Losing weight can help your Losing weight can help your kidneys work as well as they can kidneys work as well as they can for as long as they can.for as long as they can.

See a Dietitian.See a Dietitian.


The kidneys are your The kidneys are your body’s waste disposal body’s waste disposal unitunit Healthy kidneys remove waste Healthy kidneys remove waste

products from the bloodstream.products from the bloodstream.

In Chronic Kidney Disease…In Chronic Kidney Disease…– Waste products can build up in your blood.Waste products can build up in your blood.– Some of these waste products come from Some of these waste products come from

the food we eat.the food we eat.– You may need to limit some foods.You may need to limit some foods.


How to tell if you need to How to tell if you need to limit some foodslimit some foods

Regular blood tests will Regular blood tests will show if any waste products show if any waste products are building up in your are building up in your blood.blood.

The Kidney Team will let The Kidney Team will let you know if you need to you know if you need to limit any particular foods.limit any particular foods.


When will you see a When will you see a Dietitian?Dietitian?

You will see a Dietitian through You will see a Dietitian through the Chronic Kidney Clinics.the Chronic Kidney Clinics.

If you start dialysis, you will see a If you start dialysis, you will see a Dietitian as your diet will change.Dietitian as your diet will change.


What to expect from the What to expect from the DietitianDietitian

The Dietitian will look at your…The Dietitian will look at your…– Medical History,Medical History,– Weight History,Weight History,– Blood Levels,Blood Levels,– Recent Dietary Intake with a Recent Dietary Intake with a

Diet History.Diet History.


Taking a Diet HistoryTaking a Diet History

Your Dietitian will ask you lots of Your Dietitian will ask you lots of questions about what you normally questions about what you normally eat.eat.

No right or wrong answers! No right or wrong answers!

Used to see if you are getting too Used to see if you are getting too much or too little of any particular much or too little of any particular nutrient.nutrient.


Which nutrientsWhich nutrients

Protein,Protein, Sodium (Salt),Sodium (Salt), Fluid,Fluid, Potassium,Potassium, Phosphate.Phosphate.


ProteinProtein

Protein is found in red and white Protein is found in red and white meats, fish, eggs, dairy products and meats, fish, eggs, dairy products and legumes.legumes.

It’s important to have the right amount It’s important to have the right amount of protein you need for growth, healing of protein you need for growth, healing and fighting infection.and fighting infection.

too much protein can too much protein can lead to a build up of a lead to a build up of a waste product called waste product called Urea.Urea.

Too little Too little protein could protein could lead to under lead to under nutrition.nutrition.


Sodium or SaltSodium or Salt

Most people eat too much salt.Most people eat too much salt.

You don’t need to add salt to get too You don’t need to add salt to get too much salt.much salt.– 75% of salt comes from processed foods.75% of salt comes from processed foods. – Corned, smoked, pickled and takeaway foods. Corned, smoked, pickled and takeaway foods.

Tinned and packet soups, sauces.Tinned and packet soups, sauces.

Too much salt Too much salt causes fluid retention and causes fluid retention and increases blood pressure.increases blood pressure.


Hints to cut down on SaltHints to cut down on Salt

Salt is an acquired taste.Salt is an acquired taste.

Limit processed foods, Limit processed foods, Limit takeaway foods,Limit takeaway foods, Avoid adding salt in cooking and at Avoid adding salt in cooking and at

the table,the table, Do not use Salt Substitutes.Do not use Salt Substitutes.


FluidFluid

Excess fluid can cause:Excess fluid can cause:– High blood pressure,High blood pressure,– Swelling in the ankles, hands and face,Swelling in the ankles, hands and face,– Shortness of breath.Shortness of breath.

Check with your Renal Team regularly Check with your Renal Team regularly about how much fluid you should drink.about how much fluid you should drink.

Fluid is not just water. Fluid is not just water. – Count anything that is liquid at room Count anything that is liquid at room

temperature.temperature.


PotassiumPotassium

Potassium is a mineral needed by the body Potassium is a mineral needed by the body to make your muscles and cells work.to make your muscles and cells work.

High or Low blood levels can be dangerous High or Low blood levels can be dangerous for your heart.for your heart.

Not everyone needs a low potassium diet.Not everyone needs a low potassium diet.– You will only need to start a low potassium You will only need to start a low potassium

diet if your blood levels are highdiet if your blood levels are high..


What does a low What does a low potassium diet look potassium diet look like….?like….? Potassium is found in a variety of foods.Potassium is found in a variety of foods.

– not just bananas!not just bananas!

If you need a low potassium diet, your If you need a low potassium diet, your dietitian will check…dietitian will check…1.1. The amount and type of fruit you eat,The amount and type of fruit you eat,2.2. If you are having too many dairy foods,If you are having too many dairy foods,3.3. Your intake of high potassium foods. Your intake of high potassium foods.

e.g. dried fruit, nuts, seeds, juices, fruit cake, salt e.g. dried fruit, nuts, seeds, juices, fruit cake, salt substitutes, caramels, chocolate, liquorice, potato substitutes, caramels, chocolate, liquorice, potato chips, tomato sauces, coffee.chips, tomato sauces, coffee.


PhosphatePhosphate

Phosphate is a mineral that is important Phosphate is a mineral that is important for strong bones and teeth.for strong bones and teeth.

High levels can weaken your bones and High levels can weaken your bones and damage your blood vessels.damage your blood vessels.


Treating a high PhosphateTreating a high Phosphate

Phosphate bindersPhosphate binders – Tablets that you take with meals.Tablets that you take with meals.– Act like a sponge to suck the phosphate out of Act like a sponge to suck the phosphate out of

your food before you absorb it.your food before you absorb it.– Cal-sup, Caltrate, Titrilac, Renagel, Alutab.Cal-sup, Caltrate, Titrilac, Renagel, Alutab.

Low Phosphate DietLow Phosphate Diet– Not everyone needs a low phosphate diet.Not everyone needs a low phosphate diet.– You will only need to start a low phosphate You will only need to start a low phosphate

diet if your blood levels are high.diet if your blood levels are high.


What does a low What does a low Phosphate Diet look Phosphate Diet look like…?like…? Phosphate is found in a variety of foods.Phosphate is found in a variety of foods.

If you need a low Phosphate Diet, the If you need a low Phosphate Diet, the dietitian will check …dietitian will check …

1.1. If you are getting the right amount of protein and If you are getting the right amount of protein and dairy foods.dairy foods.

2.2. If you are getting too many high phosphate If you are getting too many high phosphate foods, particularly between meals.foods, particularly between meals.

e.g. chocolate, cola drinks, nuts and seeds, some e.g. chocolate, cola drinks, nuts and seeds, some types of fish.types of fish.


Everyone is different…Everyone is different…

Your kidney team will tell you if Your kidney team will tell you if you need to start a special diet.you need to start a special diet.

There is no need to avoid There is no need to avoid potassium or phosphate foods potassium or phosphate foods unless your blood levels are high.unless your blood levels are high.


Everyone is different…Everyone is different…

There is no one special diet for There is no one special diet for people with renal disease.people with renal disease.

It all depends on… It all depends on… – Your level of renal function.Your level of renal function.– What your blood tests show.What your blood tests show.– What kind of dialysis you choose.What kind of dialysis you choose.


Any Questions?Any Questions?

this is a consensus document from queensland health dietitians/nutritionists. developed: jan 2009...

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