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Nutritional Assessment

Catherine Whitford

University of South Florida

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Nutritional Assessment

Proper nutrition is essential for the prevention and treatment of diseases. A nutritional

assessment is important to implement because different illnesses require different food

requirements and restrictions. This paper introduces Mr. Jaba The-Hutt who has been recently

diagnosed with renal insufficiency, and is borderline chronic renal failure. The disease process,

treatment, nutritional needs, and patient education will be discussed further.

Disease process

Chronic renal failure is defined as the irreversible reduction in renal function, or

glomerular function, and glomerular filtration rate (GFR), with accompanying derangements in

biochemical homeostasis (Gregory, 2007). Manifestations can include GFR below 60-

mL/min/1.73 m2 and/or the presence of persistent albuminuria, proteinuria, hematuria, and/or

electrolyte imbalances (Litbarg, 2018). Maladaptive changes can lead to an increase in oxidative

stress, production of proinflammatory cytokines, activation of the renin-angiotensin-aldosterone

system, and cellular apoptosis (Litbarg, 2018). Leading to further nephron damage and loss by

glomerulosclerosis, tubular atrophy, and interstitial fibrosis (Litbarg, 2018).

Treatments

Dialysis and kidney transplants are the main treatments for those suffering from CKD. There

are two types of dialysis Hemodialysis (IV filtration) and Peritoneal Dialysis (Abdomen wall

filtration). Both work by removing waste, salt and extra water to prevent them from building up

in the body, keeping a safe level of certain chemicals in your blood, such as potassium, sodium

and bicarbonate, and helping to control blood pressure (2018).

Nutritional Requirements and Education

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Nurses should educate CKD patients on the importance of limiting food with potassium,

phosphorus, low-quality proteins, and sodium in between dialysis sessions. High levels of

potassium can be dangerous to the electric conductivity of the heart. Patients should limit

potassium-rich foods such as avocados, bananas, kiwis, and dried fruit is recommended (2016).

Patients can substitute for lower potassium foods such as apples, peaches, carrots, and green

beans (2016). Too much phosphorus in your blood pulls calcium from your bones, making your

bones thin, weak, and more likely to break (2016). Patients should limit high-phosphorus foods

like beans, oatmeal, and dairy foods (2016). Patients can substitute for pasta, fresh fruits, and

vegetables (2016). Ingesting high levels of protein cause the kidneys to work harder to remove

waste (2016). Patients should eat small portions of high-quality protein such as meat, poultry,

and eggs (2016). Patients should avoid processed meats such as hot dogs and canned chili

(2016). Excess fluid can build up in your body and may cause swelling and weight gain between

dialysis sessions, changes in your blood pressure, the heart works harder, which can lead to

serious heart trouble, and a buildup of fluid in your lungs, making it hard for you to breathe

(2016). Dialysis only removes so much fluid from the body so it is importance to limit fluid

intake by avoiding sodium, which makes patients thirsty (2016).

Conclusion

Chronic Kidney Disease is a progressive and multifaceted illness. One of the biggest

concerns with this disease process is making sure the body is receiving the nutrients it needs and

removing excess nutrients it doesn’t. Properly monitoring a patient’s intake and output will help

improve quality of life.

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Reference

Eating & Nutrition for Hemodialysis. (2016, September 01). Retrieved from

https://www.niddk.nih.gov/health-information/kidney-disease/kidney-

failure/hemodialysis/eating-nutrition

Eating Right for Chronic Kidney Disease. (2016, October 01). Retrieved from

https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-

ckd/eating-nutrition#potassium

Gregory, M. (2007). Comprehensive Pediatric Hospital Medicine. Elsevier.

doi:https://doi.org/10.1016/B978-032303004-5.50113-7

Litbarg, N. O. (2018). Integrative Medicine. Elsevier.

doi:https://doi.org/10.1016/B978-0-323-35868-2.00040-2

What is Dialysis? (2018, July 02). Retrieved from

https://www.kidney.org/atoz/content/dialysisinfo
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