Running head: PATIENT EDUCATION FOR A renal diet 1

Patient Education for a Renal Diet

Jamie L Steele

University of South Florida

College of Nursing
PATIENT EDUCATION FOR A Renal diet 2

As a patient with renal insufficiency being put on a renal diet is a way to try and prevent

further kidney damage. This is a part of the treatment for borderline kidney failure and renal

insufficiency. One reason this diet is so important to follow is because kidney function is

essential for eliminating elements from our body through urine. Elements such as potassium,

urea, sodium, phosphate as well as fluids. If the kidneys are not working properly these

substances will build up in the body, mainly the kidneys. One way a patient can prevent further

damage is by monitoring as well as limiting the intake of items such as: potassium, phosphate,

sodium, fluids. This is essential due to the fact that kidneys are removing these wastes and

materials from the foods that one eats as well as the rest of the body.

Starting with potassium, items covered will be how to control potassium levels as well as

intake of potassium. This element is necessary for the body, to maintain a balance between cells

of the body and body fluids. This element is typically removed through urination however the

kidneys are not working properly therefore the body is unable to remove the element. Typically

one wants to limit the potassium intake to 2000 mg per day. If the potassium is not regulated this

can be detrimental to ones health as superbly high potassium levels can cause an irregular heart

beat and even cause the heart to stop. Unfortunately symptoms of hyperkalemia often do not

appear until it is too high. This is why these levels are checked regularly. Foods that are high in

potassium should be avoided, but if one wants to eat them these need to be in moderation, and

the health care provider should be notified of this. High potassium foods include bananas, orange

juice, avocadoes, prunes, oranges, prune juice, tomatoes, tomato juice, tomato sauce, cantaloupe,

tomato puree, honeydew melon, nuts, papaya, chocolate, red beans, milk, white beans, lima

beans, garbanzo beans, black beans, lentils, split peas, and baked beans. Another item that should
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be avoided is salt substitutes as these items are high in potassium, and salt is an additional

component of the diet to decrease intake of (Virginia Commonwealth, n.d.).

Sodium also known as salt, is a component of everyones diet, however in the patient

with renal insufficiency it can cause one to retain water due to the kidneys inability eliminate

water as well. This sodium restriction can come up as No added salt or to eat foods that say on

the label, no added salt, no salt, low sodium, sodium free. Meats that are salty should also be

bypassed, these are meats such as bacon, ham, hot dogs, lunch meats, canned meats, bologna,

and sausages. Others that one can bypass in the store are bottled sauces, pickles, olives, and

foods containing MSG. Anything in a bottle or can most likely have salt as a preservative in

them. Salty snacks are a no, no, meaning avoid the snack aisle when walking through the

grocery store (Virginia Commonwealth, n.d.).

Protein is needed as this is important in growth and maintaining the tissues of the body.

This also helps with healing when injured, fighting off infections, and providing the body energy.

Ensure seven to eight ounces of protein is ingested every day. Foods high in protein include pork,

chicken, fish, eggs, turkey, seafood, veal, and beef. For easy reference one egg is one ounce of

protein, and three ounces of protein is the size of a deck of cards (Virginia Commonwealth, n.d.).
Phosphorous is another mineral our kidneys normally excrete through urine. However,

like the other minerals and elements if the kidneys are failing this will build up in the blood and

can cause further health problems. Health problems like muscle pains and aches, brittle and

easily broken bones, hardening (calcifications) of the heart, skin, joints as well as blood vessels.

Ways one can keep these levels in check are by limiting foods that are high in phosphorous.

Foods that are high in this are: meats, fish, dairy and poultry. Meaning the patient wants to limit

the servings of these to only seven to eight ounces a day. Milk and dairy products should be

reduced to serving sizes of 4 oz. per day. Foods that should be bypassed completely are items

such as: Lima, black, red, white and garbanzo beans. As well as, black eyed peas, and dark or
PATIENT EDUCATION FOR A Renal diet 4

unrefined grains. Skip the delicious refrigerated doughs made by the Pillsbury dough boy, along

with the scrumptious chocolates and dark colored sodas. One should also avoid the dried

vegetables and fruits. But one does not want to forget those potassium binders that are prescribed

by the doctor. These are to be taken with meals and snacks. One should limit phosphorous intake

to 1000 mg per day (Virginia Commonwealth, n.d.).

Fluids! These are essential to maintain life as the body is 70% water. However

when the kidneys do not function properly the body tends to retain much of the fluid that is

typically excreted through urine. Thus putting the excess fluid into the bodys system which will

put pressure that is not needed on the lungs and heart two vital organs. There will be an

allowance of fluid intake also called a fluid restriction. This is determined individually by the

physician. Typically though not drinking more than around 4 cups of water a day. As around 500

ml of fluid is consumed from a typical days meal. Foods that are highly fluid based are any

items that melt at room temperature and are included in the fluid restriction. These items include

but are not limited to Jell-O, popsicles, and fruit ices. The fluid restriction is a vital part of the

diet as since the water is not leaving through urine it is in the body and as said above apply

pressure on organs that are vital. This can cause further health problems but also causes weight

gain. Therefore daily weights are a vital component of the diet. If the weight increase is

exceeding 3kg in a week the physician needs to be notified. This number is derived from the fact

that there is an expected daily weight gain of 0.4-0.5kg per day from the water that is in foods

that one eats (Virginia Commonwealth, n.d.).

Overall there are many key components to maintaining a renal diet to prevent further

kidney damage. Ranging from watching the potassium, phosphorous, and sodium intakes. To

ensuring one is getting sufficient protein and restricting fluid intakes. But there are many sources

out there to aid one in this journey. Support groups, cookbooks, and nutrition guides. Along with
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multiple literature sites one can get access to from a simple google search. Though ensure these

are credible sources such as the NIH, Cleveland clinic or a hospitals education packet to name a

few. The NIH has an excellent renal diet that would be a great follow up educational tool to use

and to look up more foods one can eat (Miller, Zieve, Black, and A.D.A.M. editorial team, 2013).

The key takeaway message is that these items can be okay if consumed in moderation hence the

restrictions, and an occasional visit to the candy store to obtain a chocolate bar will not be the

worst thing as long as it is approved by the doctor and is not an excessive trip. Meaning no

chocolate bars once a week, but maybe a treat for ones birthday or a special occasion may not be

the worst thing to occur. The overall goal is to create a healthy lifestyle one can maintain and

personalize. This is not a short-term process, it is a life changing event (Virginia Commonwealth,

n.d.).

References

Scott Miller, MD, David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team (2

October 2013). Diet Chronic Kidney Disease. Retrieved from

http://www.nlm.nih.gov/medlineplus/ency/article/002442.htm
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Virginia Commonwealth University Health System (n.d.) The Renal Diet: a Guide to Eating

Healthier for Hemodialysis Patients. Retrieved from

http://www.vcuhealth.org/transplant/docs/renal_diet.pdf