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
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.
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.
Limited/prescribed amounts of sodium, sugar and fat.
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