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Renal Transplantation

Q
WHAT’S THE ROLE OF KIDNEY IN BODY?

A
Functions of kidney are:

  • Filteration of blood and removal of toxins by producingurine.
  • Maintaining the level of sodium potassium calcium and water.
  • Active role in control of bloodpressure.
  • Helps in formation of blood.
  • Synthesis of VITAMIN D3(bone formation)

Q
WHAT ARE CAUSES OF RENAL/KIDNEY DISEASES ?

A
  • Ageing
  • Hereditary
  • Metabolic disorders (hyperglycemia, hypercholesterolemia, hyperuremia)
  • Hypertension
  • Polycystic kidneys
  • Kidney stones
  • Systemic lupus erythematosus
  • Nephrotic and Nephritic syndrome
  • Acute Kidney Failure

Q
WHAT ARE THE DIETARY IMBALANCES CAUSED DUE TO KIDNEY/RENAL DISEASES ?

A
  • Water retention
  • Anaemia
  • Hyperkalemia
  • Hyperprotinemia
  • Hyperphosphatemia
  • Hypoalbuminemia
  • Vitamin D deficiency

Q
WHAT IS THE ROLE OF DIET IN KIDNEYS ?

A
  • Nutritional modification for managing optimal levels of sodium, potassium, phosphate,
    Protiens and fluid in kidney disease.
  • Limiting dietary protein to slow down progression of kidney disease.
  • Achieving strict glycemic control to slow progression of diabetic nephropathy.
  • Reduction or moderation of salt intake for management of hypertension.
  • guidelines on intake of foods containing calcium, oxalates, phosphates,
    Purines to minimize the risk of stone formation.
  • Provide adequate nutritional support to avoid malnourishment.
  • Guidelines for consumption of iron rich foods to prevent anaemia.

Q
What are the dietary principles of kidney disease ?

A
  • Low protein
  • Low salt(Sodium)
  • Low potassium
  • low phosphate
  • Fluid control

Q
Which are very high protein foods ?

A
Milk and milk products, pulses, eggs, fish, chicken, meat, beef and pork are very high protein Foods.

Q
Which are the moderate protein foods ?

A
Cereals like rice and rice products, wheat, jowar, ragi, cornflakes, maida.

Q
Which are the low protein foods ?

A
All fruits and vegetables, sabudana, arrowroot, ghee, oil, honey and jaggery are low protein foods .

Q
How to manage salt intake in kidney diseases ?

A
  • Avoid table salt.
  • Avoid packed and processed food.
  • Make a packet of prescribed amount of salt and use that salt for preparing your food
  • Avoid salty foods like papad, pickles, chutneys, seasoning’s, sauces, bakery products and dried fish
  • Add limejuice(few drops), spices, vinegar to make food more palatable.

Q
How to control potassium intake in foods ?

A
  • Potasium is present in all the foods, the bestway to control potassium is to control the serving size.
  • Avoid beverages like tea, coffee, chocolate drinks (can be taken as prescribed)
  • Avoid coconut, coconutwater, fruitjuices.
  • Can have fruits like apple, pineapple, pear, papaya, guava.
  • Spices and condiments should be used in small quantities (do not grind).
  • Leaching of vegetables helps in better potassium control.

Q
Methods of leaching ?

A
There are two methods of leaching:
METHOD 1
Soak cut vegetables in warm water for 2-3hrs. Discard the water. Add freshwater and then cook the vegetables.


METHOD 2
Wash and cut the vegetables without peeling . Add less water then needed boil for 5-7mins discard the water and then use the vegetables

Q
Fluid management in kidney disease ?

A
Fluid intake depends on factors like water retention (edema), and urinary In general Fluid intake = Previous days urine output + 500ml.

Q
How to check daily water intake ?

A
Store recommended amount of water in a bottle. Using water for tea, coffee, dal, soup, curry from the stored bottle gives a better record of water intake.

Q
Foods to be avoided

A
Buffalo milk, cheese, meat, saltwater fish, pickles, seasonings, coconut water, nuts(dry fruits)

Q
What are the dietary modifications for diabetic patients ?

A
Diabetics have to be more restrictive about starchy foods like rice, sabudana(sago) arrowroot, honey, jaggery, sugar. All the other instructions are similar as a normal renal patient.

Q
Dietary principles for dialysis patient?

A
  • Adequate protiens
  • Low salt
  • Low potassium
  • Low phosphorus
  • Fluid control

Q
Protiens in dialysis ?

A
Since dialysis contributes to loss of protiens you need to eat more protiens to replace it. Patients receiving haemodialysis should take per day protiens approximately 1- 1.2g/kg body weight and about 50% should come from high biological value protein foods.

Q
High biological value protein foods ?

A
  • Lean meat
  • Skim milk
  • Egg whites
  • Pulses
  • Fish( river water )

Q
Phosphates and potassium in dialysis ?

A
High levels of phosphates and potassium cause heart problems, also leading to muscle and bone weakness.Foods specifically banana, tomatoes, cheese, milk, curd should be limited.

Q
Salt and water intake in dialysis ?

A
Salt and fluid intake depends upon edema(water retention) and urinaryoutput of the patient.

Q
Understanding lab indicators?

A
Glomerular filteration rate (GFR): Shows how well your kidneys are working.
Creatinine (used to calculate GFR): Shows how well your kidneys are working.
Albumin: Tells wether your dietery protein is adequate.
Transferin saturation(TSAT): Indicates the ability of blood formation.
Parathyroid hormones(PTH): Imbalance may cause bone loss.
Calcium and Phosphorus: Imbalance may cause bone loss.
Potassium: Imbalance may disturb heart function.

Q
Dietary principles for kidney transplant patient ?

A
Increase protein intake
Limited/prescribed amounts of sodium, sugar and fat.

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