F.1.

Renal Failure (Acute)

Overview:

Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels
of wastes may accumulate, and your blood's chemical makeup may get out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops
rapidly, usually in less than a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care.
Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal
or nearly normal kidney function. Signs and symptoms of acute kidney failure may include: Decreased urine output, although occasionally urine output remains normal, Fluid
retention, causing swelling in your legs, ankles or feet, Shortness of breath, Fatigue, Confusion, Nausea, Weakness, Irregular heartbeat, Chest pain or pressure, Seizures or coma
in severe cases.

Disease Description Dietary Measure/ Intervention Rationale Nutritional Monitoring

Acute Renal Failure
Is commonly defined as an
abrupt decline in renal function,
clinically manifesting as a
reversible acute increase in
nitrogen waste products—
measured by blood urea
nitrogen (BUN) and serum
creatinine levels—over the
course of hours to weeks.
 Choose a Renal Diet
 Eat foods with less
sodium
 help promote kidney
function and slow the
progression of complete
kidney failure. It is low in
sodium, phosphorous,
and protein.
 Too much sodium can
make you thirsty, which
can lead to swelling and
raise your blood
pressure. This can
damage your kidneys
more and make your
heart work harder.
 Monitor sodium intake.
Too much sodium can
be harmful for people
with kidney disease
because their kidneys
cannot adequately
eliminate excess sodium
and fluid from the body.
 Monitor potassium
intake. When the
kidneys fail, they can no
longer remove excess
potassium, so potassium
levels build up in the
body. High potassium in
the blood is called
hyperkalemia
 Monitor phosphorus
intake. When kidney
function is
compromised, the
kidneys no longer
 remove excess
phosphorus. High
phosphorus levels can
pull calcium out of your
bones, making them
weak.

F.2. Renal Failure (Chronic)

Overview:

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are
then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly
impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress
to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Chronic Renal Failure
Chronic kidney disease, also
called chronic kidney failure,
describes the gradual loss of
kidney function. Your kidneys
filter wastes and excess fluids
from your blood, which are then
excreted in your urine.
 Reduce sodium intake
 Eat kidney-friendly
protein food such as
chicken, cottage cheese,
fish, Greek yogurt, etc.
 Choose a Renal Diet
 To control blood
pressure. High-blood
pressure can damage
your kidneys.
 To help maintain the
albumin level.
 help promote kidney
function and slow the
progression of complete
kidney failure. It is low
 Monitor fluid intake.
Fluid control is
important for patients in
the later stages of
Chronic Kidney Disease
because normal fluid
consumption may cause
fluid build up in the
body which could
become dangerous.
 Monitor albumin level. A
is a protein found in the
 in sodium, phosphorous,
and protein.
blood, and is essential in
maintaining growth and
repairing tissues. A
healthy albumin for
people with kidney
disease is 4.0 g/dL or
higher.

G. endometriosis

Overview:

Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows
outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic
organs.

With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has
no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated,
eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.

Endometriosis can cause pain — sometimes severe — especially during menstrual periods. Fertility problems also may develop. Fortunately, effective treatments are available.

endometriosis Endometriosis is defined as the
presence of endometrial glands
and stroma outside the
endometrial cavity and uterine
musculature. Surgical
appearance varies significantly
from superficial blebs to
infiltrating fibrosis. Direct
visualization confirmed by
histological examination remains
 Increase Intake of
Omega-3 Fats
 High fiber intake
 Gluten-Free or Low-
FODMAP Diet
 Omega-3 Fats are
healthy, anti-
inflammatory fats that
can be found in fatty fish
and other animal and
plant sources.
 may lower estrogen
levels
 to decrease pain and
lowers chance of
 CA125 Test — This is a
blood test that checks
levels of a blood protein
known as CA125, which
is a tumor marker for
certain gynecological
cancers, but is also used
to detect a specific
protein found in the
blood of women who
 essential for diagnosis. developing have endometriosis.
endometriosis.  Be mindful with foods
that can affect hormonal
level particularly
estrogen level, it could
negatively affect women
with endometriosis.

H. polycystic ovary syndrome

Overview:

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods
or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart
disease.

Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:

 Irregular periods. Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year,
more than 35 days between periods and abnormally heavy periods.

 Excess androgen. Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-
pattern baldness.

 Polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.
 polycystic ovary syndrome Polycystic ovary syndrome
(PCOS) is a common condition
that affects how a woman's
ovaries work. ... irregular periods
– which means your ovaries do
not regularly release eggs
(ovulation) excess androgen –
high levels of "male" hormones
in your body, which may cause
physical signs such as excess
facial or body hair.
 Diets high in fruits,
vegetables, whole
grains, and legumes
 Low-fat, plant-based
diet
 reduce oxidative stress
and inflammation.
 It causes weight loss and
reduces insulin
resistance, which affects
50%-70% of women
with PCOS.
 Weight loss and exercise
 Monitor the amount of
intake for food with
boosting testosterone
components such as
tuna, egg yolks, oysters,
and etc., since PCOS is a
disorder involving
excessive androgen
production.
may be beneficial; even
small weight reductions
may improve fertility.

13. Pregnancy Related

A. Gestational Diabetes

Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes
causes high blood sugar that can affect your pregnancy and your baby's health.

Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary,
taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy.

In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue
working with your health care team to monitor and manage your blood sugar.

Gestational Diabetes
GDM is impaired glucose
tolerance that first appears
during pregnancy. Hormones
secreted by the placenta—
estrogen, progesterone, growth
hormone, corticotrophin-
releasing hormone, and
 Eat healthy foods.
 Choose foods high in  control of
fiber and low in fat and hyperglycemia;
calories. Focus on fruits, adequate weight gain;
vegetables and whole and appropriate
grains. Strive for variety nutritional status
to help you achieve your  Maintain adequate
goals without weight gain in
 prolactin—oppose insulin’s
function, and the pancreas
struggles to produce enough
insulin to compensate for the
greater caloric intake during
pregnancy.
 Keep active. Take a brisk
daily walk. Ride your
bike. Swim laps.
 Lose excess pounds
before pregnancy.
compromising taste or pregnancy and
nutrition. prevention of
 Exercising before and exacerbated weight gain
during pregnancy can through hypocaloric
help protect you from diets
developing gestational  Monitoring
diabetes. Aim for 30 carbohydrates
minutes of moderate
activity on most days of
the week.
 losing extra weight
beforehand may help
you have a healthier
pregnancy.

B. Pregnancy Induced Hypertension

Overview:

Pregnancy-induced hypertension (PIH), also called toxemia or preeclampsia: This condition can cause serious problems for both the mother and the baby if left untreated. PIH
develops after the 20th weeks of pregnancy. Along with high blood pressure, it causes protein in the urine, blood changes and other problems.

The following are the 3 common types of gestational hypertension:

Chronic Hypertension– Women who have high blood pressure (over 140/90) before pregnancy, early in pregnancy (before 20 weeks), or continue to have it after delivery.

Gestational Hypertension– High blood pressure that develops after week 20 in pregnancy and goes away after delivery.

Preeclampsia – Both chronic hypertension and gestational hypertension can lead to this severe condition after week 20 of pregnancy. Symptoms include high blood pressure and
protein in the urine. This can lead to serious complications for both mom and baby if not treated quickly.
 Pregnancy Induced Hypertension in pregnancy
Hypertension generally refers to a blood
pressure (BP) of 140/90 mm Hg
or above.
 A diet rich in vegetables
and fish
 Avoid Western diet –
high in potatoes, meat,
white bread and
margarine.
 Avoid too much salty
food
 Stay hydrated
 linked to lower risk of
high blood pressure
during pregnancy
 increase the odds of
developing these
conditions during
pregnancy.
 Possible increase in BP
 To achieve normal blood
pressure level
 Monitor for an accurate
blood pressure. Blood
pressure measurements
should be interpreted in
the context of the stage
of pregnancy and the
expected changes in
blood pressure for each
trimester.

C. Hyperemesis Gravidarum

Overview:

Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Mild cases are treated with dietary changes, rest, and
antacids. More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line (IV). DO NOT take any medications
to solve this problem without first consulting your health care provider. This condition may cause volume depletion, electrolytes and acid-base imbalances, nutritional
deficiencies, and even death. Severe hyperemesis requiring hospital admission occurs in 0.3-2% of pregnancies. The defining symptoms of hyperemesis gravidarum are
gastrointestinal in nature and include nausea and vomiting. Other common symptoms include ptyalism (excessive salivation), fatigue, weakness, and dizziness

Hyperemesis Gravidarum
Hyperemesis gravidarum is the
most severe form of nausea and
vomiting in pregnancy,
characterized by persistent
nausea and vomiting associated
with ketosis and weight loss
(>5% of pre-pregnancy weight).
 high protein and high
calorie
 Eat a small meal or
snack every 2 hours
rather than 3 large
meals every day.
 Eat a small snack before
 to maintain weight  Monitor weight (loss or
because of possibility of gain.)
weight loss due to  Monitor for signs of
nausea and vomiting. dehydration.
 To prevent nausea
because you will never
be hungry.
 This may prevent nausea
 going to sleep at night. in the morning when
you wake up.
 Drink most of your  To prevent dehydration.
liquids between meals.

D. Placenta Previa

Overview:

Placenta previa is an obstetric complication that classically presents as painless vaginal bleeding in the third trimester secondary to an abnormal placentation near or covering
the internal cervical os. However, with the technologic advances in ultrasonography, the diagnosis of placenta previa is commonly made earlier in pregnancy. Historically, there
have been three defined types of placenta previa: complete, partial, and marginal. More recently, these definitions have been consolidated into two definitions: complete and
marginal previa.

A complete previa is defined as complete coverage of the cervical os by the placenta. If the leading edge of the placenta is less than 2 cm from the internal os, but not fully
covering, it is considered a marginal previa

The placenta is a structure that develops inside your uterus during pregnancy, providing oxygen and nutrition to and removing wastes from your baby. The placenta connects to
your baby through the umbilical cord. In most pregnancies, the placenta attaches at the top or side of the uterus.

Placenta previa (pluh-SEN-tuh PREH-vee-uh) occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause
severe bleeding during pregnancy and delivery.

If you have placenta previa, you might bleed throughout your pregnancy and during your delivery. Your health care provider will recommend avoiding activities that might cause
contractions, including having sex, douching, using tampons, or engaging in activities that can increase your risk of bleeding, such as running, squatting, and jumping.

You'll need a C-section to deliver your baby if the placenta previa doesn't resolve.

Placenta Previa Placenta Previa is a condition
where the placenta lies low in
the uterus and partially or
completely covers the cervix.
The placenta may separate from
the uterine wall as the cervix
 Fruit and vegetables diet  For a complete vitamins
and nutrients that helps
prevent any
complications.
 Recommended intake of
Iron during pregnancy.  Reduces the
 Monitor weight gain to
avoid any serious
complications.
 Excessive or insufficient
weight gain can
undermine the health of
 begins to dilate (open) during complications of both the fetus and the
labor placenta previa such as mother.
preterm birth.

References:

https://nephcure.org/livingwithkidneydisease/diet-and-nutrition/renal-diet/

https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

https://www.healthline.com/nutrition/endometriosis-diet-tips#section7

https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342095/all/Polycystic_Ovary_Syndrome#3

https://familydoctor.org/condition/pregnancy-induced-hypertension/

https://emedicine.medscape.com/article/254751-overview

https://americanpregnancy.org/pregnancy-complications/hyperemesis-gravidarum/

https://www.drugs.com/cg/hyperemesis-diet.html

https://www.medicalnewstoday.com/articles/246404.php#supplements

https://www.mayoclinic.org/diseases-conditions/placenta-previa/diagnosis-treatment/drc-20352773