NUR 242 Nutrition

Study Guide Ch 22 Renal

Vocab: Bowman’s capsule, glomerulus, nephron, tubules, hypoalbuminemia, erythropoietin,

albuminuria, hypoalbuminuria, oliguria, anuria, uremia, glomerular filtration rate

Roles of kidneys—don’t forget renin, erythropoietin and activating Vitamin D, besides the usual
roles we think of:

Renal labs: BUN, Serum Creatinine, GFR. What are these measuring? Do they go up or down
as kidneys fail?

Nephrotic syndrome
Description
Causes
Consequences (Figure 22-2)
Treatment

Acute Kidney Injury (AKI)

Description
Causes (Table 22-2) Minimum things to remember:
Prerenal usually caused by low blood pressure/volume ie shock, hemorrhage…
Intrarenal—infections, drugs
Postrenal—kidney stones, obstructions
Treatment—dialysis, drugs, nutrition
Nutrition: energy needs usually high because these pts are typically hypermetabolic.
Protein should be enough for nitrogen balance (prevent muscle wasting), but not extra, so as to
not overwork kidneys with extra nitrogenous waste to get rid of (urea).

Chronic Kidney Disease (CKD)

Description
Most common causes (list 2)
Difference between chronic and end-stage kidney disease
Consequences of CKD:
Uremic syndrome—what stage of kidney disease is this seen in? Clinical signs/symptoms
include:
Table 22-5—what nutrients are typically involved in CKD?
Nutritional therapy for CKD (see summary slide):

Foods high in potassium (table 22-6)—be able to list 5 foods high in K:

Bananas, oranges, apricots, spinach, pumpkin/winter squash, potatoes, tomatoes, beans, milk,
yogurt
(This list is adapted from the Comprehensive NCLEX-RN Review)

Phosphorus—comes with high-protein foods (meats, legumes, milk) and also many other foods.
Phosphate binders are needed on dialysis, when patients need to eat more protein to make up for
the losses in dialysis.

Which macronutrient takes priority when planning a renal diet? Carb, fat or protein?
(Protein—just enough protein to keep from wasting muscles; not any extra so as to not
overwork kidneys with more nitrogenous waste to get rid of.)

Kidney Stones
What to do to avoid getting kidney stones in general:

What to do to avoid making calcium-oxalate stones: