UNIVERSITY OF NIGERIA

ENUGU CAMPUS

FACULTY OF HEALTH SCIENCE AND

TECHNOLOGY

DEPARRTMENT OF NURSING SCIENCES

A PRESENTATION IN PARTIAL FULLFILLMENT

OF THE COURSE
NUTRITION IN ILLNESS AND HEALTH

LECTURER: DR. OGBONNA PLEASURE

February 19, 2024
 TABLE OF CONTENT
Interrelationships Between Nutrients and Kidney Function
Effect of Nutritional Intake on the Rate of Progression of Renal Failure
Nutritional Alterations in the Nephrotic Syndrome
Nutritional and Metabolic Consequences of Chronic Renal Failure
Clinical, Nutritional, and Metabolic Disorders
Wasting Syndrome
Dietary Management of Chronic Renal Disease and Chronic Renal Failure
General Principles of Dietary Therapy
Nutritional Therapy in Acute Renal Failure
Chapter References
Introduction:
Chronic kidney disease (CKD) affects millions of individuals worldwide, presenting a significant
challenge to healthcare systems and patients alike. As CKD progresses, dietary interventions
play a pivotal role in managing symptoms, slowing disease progression, and improving overall
quality of life. This paper aims to explore the intricate relationship between nutrition and renal
health, providing insights into tailored dietary strategies for individuals navigating the
complexities of renal disease. By examining the latest research and clinical guidelines, we
endeavor to equip healthcare professionals and patients with evidence-based nutritional
interventions to optimize outcomes and promote renal wellness.

INTERRELATIONSHIP BETWEEN NUTRIENTS AND KIDNEY FUNCTION

SODIUM
Sodium is a mineral found in most natural foods. Most people think of salt and sodium as
interchangeable. Salt, however, is actually a compound of sodium and chloride. Foods we eat
may contain salt or they may contain sodium in other forms. Processed foods often contain
higher levels of sodium due to added salt.

Sodium is one of the body’s three major electrolytes (potassium and chloride are the other two).
Electrolytes control the fluids going in and out of the body’s tissues and cells. Sodium
contributes to:
Regulating blood pressure and blood volume
Regulating nerve function and muscle contraction
Regulating the acid-base balance of blood
Balancing how much fluid the body keeps or eliminates

SODIUM INTAKE IN RENAL DISEASES

Too much sodium can be harmful for people with kidney disease because their kidneys cannot
adequately eliminate excess sodium and fluid from the body. As sodium and fluid build up in the
tissues and bloodstream, they may cause:
● Increased thirst
● Edema: swelling in the legs, hands, and face
● High blood pressure
● Heart failure: excess fluid in the bloodstream can overwork the heart, making it enlarged
and weak
● Shortness of breath: fluid can build up in the lungs, making it difficult to breathe

POTASSIUM
Potassium is a mineral found in many of the foods we eat and is also found naturally in the body.
Potassium plays a role in keeping the heartbeat regular and the correct functioning of the
muscles. Potassium is also necessary for maintaining fluid and electrolyte balance in the
bloodstream. The kidneys help in regulation of potassium in the body and they expel excess
amounts into the urine.

POTASSIUM INTAKE IN RENAL DISEASES PATIENTS

In renal diseases, the kidneys fail and can no longer remove excess potassium, so potassium
levels build up in the body. High potassium in the blood is called hyperkalemia which can cause:
● Muscle weakness
● An irregular heart beat
● Slow pulse
● Heart attacks
● Death

PHOSPHORUS

Phosphorus is a mineral that is critical in bone maintenance and development. Phosphorus also
assists in the development of connective tissue and organs and aids in muscle movement.
When food containing phosphorus is consumed and digested, the small intestines absorb the
phosphorus so that it can be stored in the bones.

PHOSPHORUS INTAKE IN RENAL DISEASES PATIENTS

Normal working kidneys can remove extra phosphorus in your blood. When kidney function is
compromised, the kidneys no longer remove excess phosphorus. High phosphorus levels can
dacalcify the bones, making them weak. This also leads to dangerous calcium deposits in the
blood vessels, lungs, eyes, and heart.

PROTEIN INTAKE IN RENAL DISEASE

Protein is not a problem for healthy kidneys. Normally, protein is ingested and waste products
like urea and uric acids are created, which in turn are filtered by the nephrons of the kidney.
Then, with the help of additional renal processes, the waste turns into urine. In contrast, damaged
kidneys fail to remove protein waste and it accumulates in the blood.
The proper amount of protein consumption for Chronic Kidney Disease patients differs with
each stage of disease. Protein is essential for tissue maintenance and other bodily roles, so it is
important to eat the recommended amount for the specific stage of disease according to your
nephrologist or renal diet

FLUIDS
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.
People on dialysis often have decreased urine output, so increased fluid in the body can put
unnecessary pressure on the person’s heart and lungs.

A patient’s fluid allowance is calculated on an individual basis, depending on urine output and
dialysis settings. It is vital to follow your nephrologist’s/nutritionist’s fluid intake guidelines.

EFFECT OF NUTRITIONAL INTAKE ON THE RATE OF PROGRESSION

OF RENAL FAILURE
The effect of nutritional intake on the rate of progression of renal failure is a topic of significant
interest in nephrology and nutrition. Adequate nutrition is crucial in managing renal failure and
slowing its progression.There is a rather common physiologic and biochemical response to
chronic loss of renal function that is largely independent of the underlying type of kidney
disease. When enough functioning nephrons are lost to cause renal insufficiency, the remaining
individual functioning nephrons show a rise in glomerularplasma flow and GFR, and both
glomeruli and tubules increase in size (i.e., nephron hypertrophy). Nutritional intake plays a
critical role in the management of CKD, as certain dietary factors can either slow down or
accelerate the progression of renal failure.
Protein Intake
Protein intake is pivotal for tissue repair and maintenance, yet excessive amounts strain
compromised kidneys. Moderate protein intake benefits muscle preservation without
overburdening renal function. Advantages include supporting lean body mass and preventing
malnutrition.Protein consumption affects renal failure progression, with excessive intake
accelerating decline due to increased renal workload. Balanced protein intake preserves muscle
mass without overtaxing kidneys.Nursing interventions involve educating patients on protein
moderation (0.6-0.8 g/kg/day), monitoring dietary intake, and collaborating with dietitians to
develop personalized meal plans.
Sodium Intake
Sodium restriction is crucial to mitigate hypertension and fluid retention, common complications
of CKD. Lowering sodium intake reduces blood pressure and diminishes oedema. Advantages
encompass blood pressure management and decreased cardiovascular risk.Nursing interventions
focus on educating patients about sodium sources, promoting label reading, and implementing
dietary modifications. Collaborative efforts with dietitians are essential to ensure adherence to
sodium restrictions (<2,300 mg/day) and optimize patient outcomes.
Potassium and Phosphorus
Elevated phosphorus and potassium levels in CKD correlate with adverse outcomes like bone
disease and cardiac complications. Restricting intake of phosphorus-rich foods like dairy and
potassium-rich foods like bananas and potatoes is paramount. Benefits include mitigating
mineral imbalances and reducing cardiovascular risk.Nursing interventions include educating
patients about phosphorus and potassium-rich foods, promoting dietary modifications, and
facilitating medication adherence. Collaborating with dietitians to develop individualized meal
plans (<800-1,000 mg/day for phosphorus, <2,000-3,000 mg/day for potassium) is crucial for
managing mineral imbalances.
Fluid Intake
CKD impairs fluid balance regulation, necessitating fluid restriction to prevent edema and
hypertension. Limiting fluid intake aids in managing volume overload and electrolyte
imbalances. Advantages include improved blood pressure control and reduced risk of fluid
overload. However, adherence to fluid restrictions may be challenging, impacting patient
satisfaction. Individualized goals, often around 1-2 liters/day, are set based on urine output and
residual kidney function.
Caloric Intake
Maintaining adequate caloric intake is crucial to prevent malnutrition and sustain energy levels
in CKD. Energy-dense foods and nutritional supplements can help meet increased energy
requirements. Advantages encompass weight maintenance and preventing malnutrition-related
complications. However, decreased appetite and metabolic alterations in CKD may hinder
caloric intake. Monitoring body weight and adjusting intake accordingly are essential.
Recommendations vary based on individual needs but often target 25-35 kcal/kg/day.

Micro Nutrients
Micronutrient deficiencies, common in renal failure, require careful management to prevent
complications. Nursing interventions include monitoring micronutrient levels, administering
supplements as prescribed, and educating patients on dietary sources. Collaborative care with
dietitians ensures tailored supplementation and dietary adjustments, optimizing micronutrient
status and supporting overall health.
The recommended daily intake of dietary calcium is 800 to 1,000 mg/day to maintain appropriate
calcium levels in patients with CKD G3, G4 who are not receiving active vitamin D analogs
[84]. These recommendations are consistent with the current estimated average requirement (800
to 1,000 mg/day) and recommended dietary allowance (1,000 to 1,200 mg/day) for healthy
individuals

Nutritional Alterations in the Nephrotic Syndrome

Nephrotic syndrome is a kidney disorder characterized by heavy proteinuria, hypoalbuminemia,
edema, and hyperlipidemia. The syndrome results from the disruption of the glomerular filtration
barrier in the kidneys, leading to protein leakage into the urine and subsequent nutritional
deficiencies. Chronic kidney disease is often associated with nephrotic syndrome, as the kidneys'
ability to filter waste and regulate fluid balance becomes compromised.

Nutritional Alterations in Nephrotic Syndrome:

- Proteinuria: Proteinuria is a hallmark feature of nephrotic syndrome, leading to excessive loss
of serum proteins, particularly albumin, in the urine. This results in hypoalbuminemia, which
contributes to edema formation due to decreased oncotic pressure. The loss of protein can also
lead to malnutrition, muscle wasting, and impaired immune function.
- Hyperlipidemia: Nephrotic syndrome is associated with dyslipidemia, characterized by elevated
levels of triglycerides and low-density lipoproteins (LDL). The dyslipidemia is a secondary
response to hypoalbuminemia and increased hepatic lipoprotein synthesis. However, it
predisposes individuals to cardiovascular disease and atherosclerosis.
- Edema: Edema is a common symptom of nephrotic syndrome, resulting from fluid retention
due to hypoalbuminemia and sodium retention. Edema management involves restricting sodium
intake to reduce fluid accumulation and managing fluid balance through diuretic therapy.
- Malnutrition: The loss of protein and essential nutrients in the urine can lead to malnutrition in
patients with nephrotic syndrome. Malnutrition can further exacerbate kidney damage and
compromise overall health. Nutritional support, including a balanced diet rich in protein,
essential vitamins, and minerals, is crucial to prevent malnutrition in individuals with nephrotic
syndrome.

Nutritional Management in Renal Disease:

Patients with nephrotic syndrome require specialized nutrition therapy to maintain kidney
function, manage complications such such as proteinuria, hyperlipidemia, edema, and
malnutrition, and improve overall health outcomes. Nutritional management in renal disease
involves the following key strategies:
 Protein Intake: Patients with nephrotic syndrome should consume adequate high-quality
protein to support muscle mass and prevent malnutrition. However, excessive protein
intake can worsen proteinuria and kidney function. Therefore, a balance between protein
intake and renal function needs to be maintained. Sources of high-quality protein include
lean meats, poultry, fish, eggs, dairy products, legumes, and tofu.
 Sodium and Fluid Restriction: Sodium and fluid restriction is crucial in managing edema
and hypertension. Limiting salt intake and monitoring fluid intake can help reduce fluid
retention and control blood pressure. Patients should avoid processed foods, canned
soups, sauces, and snacks high in sodium. Instead, fresh fruits and vegetables, whole
grains, and lean proteins can be included in the diet.
 Potassium and Phosphorus Control: Restrictions on potassium and phosphorus intake to
prevent electrolyte imbalances and mineral buildup in the blood. Foods high in
potassium, such as bananas, oranges, potatoes, and tomatoes, and phosphorus-rich foods,
like dairy products and nuts, should be limited. Working with a dietitian to create a
customized meal plan is essential to ensure proper nutrient balance.
 Fluid Management: Monitoring fluid intake is crucial to prevent fluid overload and
maintain electrolyte balance. Patients may need to restrict fluids based on their urine
output, kidney function, and individual needs. Adequate hydration is important, but
excessive fluid intake can strain the kidneys and worsen edema. Engaging in regular
physical activity and avoiding sugary beverages can help in managing fluid intake.
 Nutrient Supplements: In some cases, nutrient supplementation, such as vitamin D, iron,
and B vitamins, to address deficiencies and support overall health. However, supplements
should be used under the guidance of a healthcare provider to prevent potential
interactions or adverse effects.
 Weight Management: Maintaining a healthy weight is important to reduce the risk of
complications and improve overall health. A balanced diet, portion control, regular
physical activity, and monitoring calorie intake can help in managing weight and
promoting overall well-being. Weight management can help control blood pressure,
improve metabolic function, and reduce the risk of cardiovascular disease, which are
common complications of kidney disease.
 Monitoring and Evaluation: Regular monitoring of nutritional status, kidney function, and
overall health is essential. Healthcare providers may conduct a thorough assessment of
dietary intake, weight changes, blood test results, and symptoms to tailor nutrition
recommendations and treatment plans. Adjustments to the diet and treatment strategy
may be necessary based on the individual's response and progress.
  Collaboration with Healthcare Team: Effective collaboration with a multidisciplinary
healthcare team, including nephrologists, dietitians, nurses, and other healthcare
professionals, is crucial in managing nutrition in renal disease.
 Education and Support: Providing education and support to patients and their families on
dietary guidelines, meal planning, food choices, and lifestyle modifications is important
in promoting adherence to nutritional recommendations and empowering individuals to
take an active role in their health. Encouraging regular follow-up visits, monitoring
progress, and addressing concerns or challenges can help ensure long-term success in
managing nutrition in renal disease.

Overall, the nutritional management of nephrotic syndrome aims to correct these imbalances and
prevent further complications. Some of the dietary recommendations are:
- Moderate protein restriction (0.8 g/kg for adults) to reduce proteinuria and preserve renal
function.
- Focus on moderate protein restriction (0.8-1.1 g/kg/day) to minimize glomerular stress while
ensuring protein needs are met. Individualization based on disease severity and renal function is
key.
- Low sodium intake (2-3 g/day) to reduce edema and blood pressure.
- Low fat and cholesterol intake to lower blood lipid levels and prevent atherosclerosis.
- Supplementation of essential amino acids, iron, vitamin D, calcium, zinc, and copper to
replenish the losses in the urine and improve serum protein status, hemoglobin, bone health, and
immune function.

CLINICAL DISORDERS OF RENAL FAILURE

Clinical disorders associated with renal failure can manifest in various ways due to the kidneys'
crucial roles in maintaining fluid balance, electrolyte levels, and eliminating waste from the
body. Some key clinical disorders include:

1. **Hypertension**: Kidney failure can disrupt the regulation of blood pressure, leading to
hypertension, which can further damage the kidneys and exacerbate cardiovascular
complications.

2. **Fluid and Electrolyte Imbalances**: Kidney failure can lead to abnormalities in fluid
balance and electrolyte levels, such as:
- Fluid retention: Inability to excrete excess fluid can result in edema (swelling) and contribute
to hypertension and heart failure.
- Hyperkalemia: Elevated potassium levels in the blood can cause cardiac arrhythmias and
muscle weakness.
- Hyponatremia or hypernatremia: Abnormal sodium levels can affect neurological function
and lead to symptoms such as confusion, seizures, or coma.
 - Hyperphosphatemia: Increased phosphorus levels in the blood can lead to bone and mineral
metabolism disorders.

3. **Anemia**: Reduced production of erythropoietin by the kidneys can lead to anemia,

resulting in fatigue, weakness, and decreased oxygen delivery to tissues.

4. **Metabolic Acidosis**: The kidneys play a crucial role in maintaining acid-base balance.
Renal failure can lead to metabolic acidosis, characterized by a decrease in blood pH, which can
impair various physiological processes.

5. **Uremic Syndrome**: This includes a range of symptoms resulting from the buildup of
waste products in the blood due to impaired kidney function. Symptoms may include nausea,
vomiting, loss of appetite, fatigue, itching, and neurological complications like confusion or
coma.

NUTRITIONAL DISORDERS OF RENAL FAILURE

1. **Protein-Energy Malnutrition (PEM):** Reduced protein intake, impaired protein synthesis,

and increased protein breakdown can lead to muscle wasting and weight loss.

2. **Electrolyte Imbalances:** Renal failure can disrupt electrolyte balance, leading to disorders
such as hyperkalemia (high potassium levels) or hypocalcemia (low calcium levels).

3. **Fluid Retention:** Inability of the kidneys to regulate fluid balance can result in edema
(fluid retention) and hypertension.

4. **Mineral and Bone Disorders:** Renal failure can cause abnormalities in mineral
metabolism, leading to conditions like renal osteodystrophy, characterized by bone pain,
fractures, and deformities due to imbalances in calcium, phosphorus, and vitamin D metabolism.

5. **Anemia:** Decreased production of erythropoietin by the kidneys can result in anemia,

leading to fatigue and weakness.

6. **Metabolic Acidosis: The kidneys are responsible for regulating acid-base balance. In renal
failure, there can be an accumulation of acidic compounds, leading to metabolic acidosis.

7. **Malabsorption of Nutrients:** Impaired kidney function can affect the absorption of various
nutrients, further contributing to malnutrition.

METABOLIC DISORDERS OF RENAL FAILURE

1. **Metabolic Acidosis:** The kidneys are crucial for excreting acids generated during
metabolism. In renal failure, impaired kidney function can lead to the accumulation of acidic
compounds, resulting in metabolic acidosis. Symptoms may include fatigue, confusion, and
abnormal heart rhythms.

2. **Electrolyte Imbalances:** The kidneys regulate the levels of electrolytes such as sodium,
potassium, calcium, and phosphate in the body. In renal failure, electrolyte imbalances can occur,
leading to conditions like hyperkalemia (high potassium levels), hyponatremia (low sodium
levels), hyperphosphatemia (high phosphate levels), and hypocalcemia (low calcium levels).
These imbalances can have various effects on nerve and muscle function, cardiac rhythm, and
bone health.

3. **Mineral and Bone Disorders:** Renal failure can disrupt mineral metabolism, leading to
abnormalities in bone mineralization and bone turnover. This can result in conditions collectively
referred to as renal osteodystrophy, which includes osteitis fibrosa cystica, osteomalacia, and
adynamic bone disease. These disorders can lead to bone pain, fractures, and skeletal
deformities.

4. **Dyslipidemia:** Renal failure is associated with alterations in lipid metabolism, leading to

dyslipidemia characterized by elevated levels of triglycerides and LDL cholesterol and decreased
levels of HDL cholesterol. Dyslipidemia in renal failure is a significant risk factor for
cardiovascular disease.

5. **Insulin Resistance and Diabetes:** Chronic kidney disease (CKD) is a risk factor for the
development of insulin resistance and type 2 diabetes mellitus. Insulin resistance can contribute
to dysglycemia and worsen metabolic control in individuals with pre-existing diabetes.

WASTING SYNDROME
Waisting syndrome, also known as cachexia, is a condition characterized by the excessive loss of
weight, particularly muscle and fat tissue, due to a debilitating illness, it is mostly found in HIV
and Cancer patients. It is not entirely reversed with nutritional supplementation and is associated
with a poor prognosis.
In children, wasting is often referred to as acute malnutrition, indicating short periods of
undernutrition leading to significant muscle and fat tissue wastage. It can be caused by severe
food shortage, disease, or both. is also called wasting syndrome or anorexia cachexia syndrome.
It is a complex problem that is more than a loss of appetite. It involves changes in the way your
body uses proteins, carbohydrates, and fat. You may also burn calories faster than usual. People
with cachexia lose muscle and often fat as well.Cachexia is very different to general weight loss.
Doctors can’t reverse it fully despite you being able to eat. Feeding through a tube is not
effective either.
 WHAT HAPPENS IN CACHEXIA
Scientists still don't know what exactly happens in cachexia. It is a complex process that involves
several organs and systems in the body. With cachexia, the cells in the muscles, fat and liver
might not respond well to insulin. This is called insulin resistance. Insulin helps to take glucose
from the blood. So the body can not use glucose from the blood for energy.
Scientists also think that cancer causes the immune system to release certain chemicals into the
blood. This causes inflammation. These chemicals are called cytokines and contribute to the loss
of fat and muscle. The chemicals may make body metabolism speed up so that calories are used
up faster than they normally would. Because the body is using up energy faster than it is getting
it, there will be severe weight loss. This can happen even if the patient is eating normally.

SYMPTOMS OF CACHEXIA
Cachexia is more common in people with lung cancer or with cancers anywhere in the digestive
system. The main symptoms are:
severe weight loss, including loss of fat and muscle mass
loss of appetite
anaemia (low red blood cells)
weakness and fatigue
WHO GETS CACHEXIA
People with early stage cancers don’t usually get cachexia. Up to 8 out of 10 people with
advanced cancer (80%) develop some degree of cachexia. Cachexia in advanced cancer can
however be very upsetting. The patient can feel very weak and less able to do things.
Cachexia isn't just associated with cancer. It is common in the advanced stages of other illnesses
such as kidney disease, heart disease, and HIV.

TREATMENT FOR CACHEXIA

Some people with cachexia will be given medicines such as appetite stimulants. But these don’t
work for all people. Ghrelin is an appetite regulating hormone found in the stomach lining.
Anamorelin is a drug that mimics this hormone and improves appetite. Researchers have found
that anamorelin might help people with cachexia. They found that it:
is safe
improved appetite
increased body weight and body mass
improved other symptoms
The results from research on anamorelin are promising so far. More research is continuing.

General Principles of Dietary Therapy

Diet therapy means use of diet (food and drink) not only in the care of the sick, but also in the
prevention of disease and maintenance of health. It is concerned with the use of food as an agent
in effecting recovery from illness.
A well planned diet providing all the specific nutrients to the body helps to achieve nutritional
homeostasis in a normal, healthy individual. However, in disease conditions, the body tissues
either do not receive proper nutrients in sufficient amounts or cannot utilize the available
nutrients owing to faulty digestion, absorption or transportation of food elements, thus affecting
the nutritional homeostasis of the sick person. The diet, therefore needs to be suitably modified.
However, it is imperative that the basis for planning such modified diets should be the normal
diet.
Therefore diet therapy is concerned with the modification of normal diet to meet the
requirements of the sick individual.
The General objective of diet therapy are;
1. To maintain a good nutritional status.
2. To correct nutrient deficiencies which may have occurred due to the disease.
3. To afford rest to the whole body or to the specific organ affected by the disease.
4. To adjust the food intake to the body's ability to metabolize the nutrients during the
disease.
5. To bring about changes in body weight whenever necessary.

The advantage of using normal diet as the basis for therapeutic diet are;
 It emphasises the similarity of psychological and social needs of those who are well, even
though there is quantitative and qualitative differences in requirements, thus ensuring
better acceptability.
 Food preparation is simplified when the modified diet is based upon the family pattern
and the number of items requiring special preparation is reduced to a minimum.
 The calculated values for the basic plan are useful in finding out the effects of addition or
omission of certain foods. e.g; if vegetables are restricted, vitamin A or Vitamin C
deficiency can occur.

Factors to consider in planning therapeutic diets.

1. The underlying diseased condition which requires a change in the diet.
2. The possible duration of the disease.
3. The factors in the diet which must be altered to overcome these conditions.
4. The patients tolerance for food by mouth.

In planning meals for a patient his economic status, his food preferences, his occupation and time
of meals should also be considered. The four attributes of a therapeutic diet are;
 Adequacy: The adequacy of a diet depends on various factors including meeting
nutritional needs, balance, variety, and portion control. A diet should provide essential
nutrients in the right amounts to support overall health and well-being of the client.
  Accuracy: The accuracy of a diet refers to how closely it aligns with recommended
nutritional guidelines and individual health goals. An accurate diet typically involves
proper portion control, balanced nutrient intake, and consideration of individual dietary
needs and preferences.
 Economic status of the patient: The economic status of a patient can significantly
influence their ability to access and afford nutritious foods, which in turn impacts their
dietary choices and overall health outcomes. Patients with lower economic status may
face barriers such as limited access to fresh produce, reliance on cheaper but less
nutritious options, and difficulty affording healthcare services.
 Palatability: The paratability of a diet refers to how appealing and enjoyable the food
within the diet is to the individual. It encompasses factors such as taste, texture, flavor
combinations, and overall satisfaction derived from eating. A diet with high paratability
is more likely to be sustainable and enjoyable, increasing the likelihood of long-term
adherence and success in achieving dietary goals.

RENAL DIET
Patients with compromised kidney function must adhere to a renal or kidney diet to cut down on
the amount of waste in their blood. Wastes in the blood come from food and liquids that are
consumed. When kidney function is compromised, the kidneys not filter or remove waste
properly. If waste is left in the blood, it can negatively affect a patient’s electrolyte levels.
Following a kidney diet may also help promote kidney function and slow the progression of
complete kidney failure.
A renal diet is one that is low in sodium, phosphorous, and protein. A renal diet also emphasizes
the importance of consuming high-quality protein and usually limiting fluids. Some patients may
also need to limit potassium and calcium. Every person’s body is different, and therefore, it is
crucial that each patient works with a renal dietitian and a nurse to come up with a diet that is
tailored to the patient’s needs.

A-DAY MEAL PLAN FOR PATIENT WITH RENAL DISEASE

DAILY MEAL MEAL TIME MEAL SERVING SIZE
BREAKFAST 8:00-8:30AM ½ cup cooked rice, pasta or cereal + ½ cup
cut up raw or cooked vegetables + 1 cup
raw leafy vegetables (cabbage) + 1-3
ounces cooked chicken or turkey (white
meat).
MID-MEAL 11.00-11:30AM 100g apple or ½ cup apple juice or ½ cup
fresh, frozen or canned fruit juice.
LUNCH 2:00-2:30PM ½ cup cooked noodles + 1 egg + ½ oz milk
or yogurt or 1½ oz cheese.
EVENING 4:00-4:30PM 1 cup of tea or toned milk + 3 cracker
 biscuits or 1 slice of bread + 1 tablespoon
sugar.
DINNER 8:00-8:30PM ½ cup cooked legumes (dry beans and
peas) + 1 oz cooked meat (lean meat) + ¼
dried fruit (pears).

Reference

REFERENCES

https://nephcure.org/livingwithkidneydisease/diet-and-nutrition/renal-diet
- https://en.wikipedia.org/wiki/Nephrotic_syndrome
- Nutritional Management of Nephrotic Syndrome -
https://www.sciencedirect.com/science/article/abs/pii/S1051227612802123
- https://www.medicalnewstoday.com/articles/nephrotic-syndrome-diet
https://www.cancerresearchuk.org/about-cancer/coping/physically/diet-problems/types/
cachexia#:~:text=Cachexia%20is%20a%20complex%20change,lose%20weight%20despite
%20eating%20normally.

https://www.brainkart.com/article/Principles-Of-Therapeutic-Diet_2613/