This document discusses nutritional considerations for the prevention and management of renal disease. It identifies dietary risk factors for kidney stones and renal failure like high protein, sodium, and sugar intake. A balanced diet low in protein, sodium, phosphorus, and potassium is recommended for chronic kidney disease. Nutritional management for nephrotic syndrome focuses on a low salt, low fat, high fiber diet. Iron deficiency anemia is common in renal patients, so the document reviews iron-rich food sources.

1. Nutritional Consideration in the
Prevention and Management of
Renal Disease
1
Imran Waheed
Demonstrator
(INS-KMU)
Applied Nutrition Unit-VII
6/15/2020

2. Objectives
At the end of this presentation the learners will be able to:
 Identify nutritional risk factors for nephrolithiasis
and renal failure.
 Discuss the role of a diet in etiology, prevention
and management of nephrolithiasis and renal
failure and during dialysis.
 Describe the nutritional management in
nephrotic syndrome.
 Review iron deficiency anemia and Iron sources
since it is common in renal patients.
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3. Risk Factors of Nephrolithiasis
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• Family or personal history
• Dehydration
• Diet……..High in protein, sodium and sugar, high
oxalate containing foods
• Obesity
• Certain supplements and medications

4. Gastric Bypass Surgery
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5. Cont….
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• Digestive diseases and surgery. Gastric bypass
surgery, inflammatory bowel disease or chronic
diarrhea can cause changes in the digestive process
that affect your absorption of calcium and water,
increasing the levels of stone-forming substances in
your urine.
• Other medical conditions. Diseases and conditions
that may increase your risk of kidney stones include
renal tubular acidosis, cystinuria,
hyperparathyroidism, certain medications and some
urinary tract infections.

6. Risk Factors For Renal Failure
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• Hereditary and genetic factors
• Obesity
• Smoking
• Hypertension
• Diabetes
• Urinary tract obstruction (renal stones)
• Drug induced e.g. Analgesics

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8. Care in Diet
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⚫Low amounts of protein
⚫Sufficient calories
⚫Low amounts of table salt (i.e. sodium)
⚫Low amounts of phosphate
⚫Low amounts of potassium
⚫Variable amounts of calcium (depending on your
individual needs)

9. Nutritional Management
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Protein:
• A balanced diet adequate in both energy and protein is
recommended.
• A very high protein diet may cause tubular damage to the
kidneys as the kidneys will have to filter more of the
proteins.
• A low protein diet (LPD) of 0.6–0.8 g/kg/day is often
recommended for the management of Chronic kidney
disease.

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11. Protein Sources
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• Foodstuffs rich in protein are:
• Cow's milk,
• Skimmed milk,
• Eggs,
• Fish, dry fish, chicken, meat,
• Cheese made from cow's milk,
• Pulses and legumes, etc.

12. Dialysis Diet
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• A dialysis diet is one that is low in sodium,
phosphorous and protein.
• A dialysis diet stresses the importance of
consuming high-quality protein and limiting
fluids.
• Some dialysis diets may also call for limited
potassium and calcium.
• Every person is different, and therefore, a
dietician will work with each patient to come up
with a dialysis diet that is tailored to his or her
needs.

13. Nephrotic Syndrome
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• Nephrotic syndrome is a renal disease which is
charactarized by high proteinuria,
hypoproteinaemia and generalized edema.
• Plasma cholesterol is usually increased.
• Nephrotic syndrome is usually caused by
damage to the clusters of small blood vessels
in your kidneys that filter waste and excess
water from your blood.

14. Nutritional Management in Nephrotic
Syndrome
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• A healthy diet for Nephrotic Syndrome
patients consists of low salt, low fat and low
cholesterol, with emphasis on fruits and
vegetables.
• The amount of protein and fluid a patient with
Nephrotic Syndrome should have depends on
the patient’s current condition, age and
weight.

15. Conti…
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• Low sodium (salt) – helps with swelling in the
hands and legs
• Lots of fresh fruit and vegetables – fiber such
as whole grains, fruits and vegetables can help
lower total and LDL cholesterol
• Low fat (1% or skim) dairy products
• Lean cuts of meat, less red meat, more
chicken and fish

16. Conti…
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• SOMETIMES fluids should be restricted, as
determined by a nephrologist
• SOMETIMES protein levels should be
increased or decreased, as determined by a
nephrologist
• RARELY should potassium or phosphorous be
restricted, only if kidneys are failing and as
determined by a nephrologist

17. Iron Deficiency Anemia
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Iron deficiency anemia occurs when your body
doesn't have enough iron.
• Iron is important because it helps you get enough
oxygen throughout your body.
• Your body uses iron to make hemoglobin.
Hemoglobin is a part of your red blood cells.
Hemoglobin carries oxygen through your body.
• If you do not have enough iron, your body makes
fewer and smaller red blood cells.
• Then your body has less hemoglobin, and you
cannot get enough oxygen.

18. Iron Rich Food
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• Cereals
• Pumpkin
• Apricots
• Potato
• Spinach
• Nuts
• Egg
• Liver
• Guava

19. References
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• Flannigan R, Choy WH, Chew B, Lange D. Renal struvite stones--
pathogenesis, microbiology, and management strategies. Nat Rev
Urol. 2014;11:333–341. [PubMed] [Google Scholar]
• Patient education: dietary and fluid compliance for patients on
hemodialysis. EBSCO Nursing Reference Center website. Available
at: https://www.ebscohost.com/nursing/products/nursing-
reference-center. Accessed June 10, 2020.
• Kidney failure: Eat right to feel right on hemodialysis. National
Institute of Diabetes and Digestive and Kidney Diseases website.
Available at: http://www.niddk.nih.gov/health-information/health-
topics/kidney-disease/kidney-failure-eat-feel-right-
hemodialysis/Pages/facts.aspx. Accessed June 11, 2020.
• Nephrotic Syndrome. The Merck Manuals Online Medical Library.
www.merckmanuals.com Accessed June 12, 2020

20. I have not failed. I've
just found 10,000
ways that won't
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work. Thomas A. Edison