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Dialysis Nutrition
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Dialysis Nutrition

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  1. Dialysis Nutrition “Information for awareness”

  2. How much do we know about our client’s nutrition? • Information can be found from… • Posters and handouts in hallway • Speaking with the dietician • Speaking with the nurse • www.kidney.org

  3. Nutritional Facts • Normal levels of Potassium • 3.5-5.5 mg/dL • Normal levels of Sodium • 2,000-3,000 mg per day • Normal levels of Phosphorous • 3.3-5.5 mg/dL • Normal levels of Cholesterol • At or below 200 mg/dL

  4. Where to start • Common sense and moderation • Avoid convenience foods, processed meats and cheeses, fast foods • Protein is extremely important • Distribute calories evenly throughout the day • Limit “pour” liquids to 32 ounces per day

  5. Too much of a good thing • Particular foods which contain phosphorous, potassium, and sodium need to be chosen from wisely • This can be accomplished with commitment, new found skills (i.e.. label reading), and a support system from heath care staff, family and friends

  6. Phosphorous • One dairy product per day… • Milk (1 cup) • Cheese (2 ounces) • Yogurt (1 cup) • Pizza (1/4 of 12 in. pizza) • Cottage Cheese (3/4 cup) • Ice Cream (1 ½ cups) • Custard (1 cup)

  7. Other Phosphorous Foods • Nuts (1/2 cup) • Waffle (2 squares) • Pancakes (2 medium) • Mac & Cheese (1 cup) • Bran Cereals (1/3 cup) • Bran muffins (1 small)

  8. Phosphorous • If Phosphorous is continually high, substitutions are possible to lower it • Rice Dream or Soymilk vs. milk • Sherbet vs. ice cream • Popcorn unsalted vs. nuts • Hamburger on a bun vs. pizza • Binders are a must to keep Phosphorous low

  9. Too much phosphorus… • Can pull calcium from your bones, which will make your bones weak and likely to break. • Also can cause skin ulcers and poor blood circulation • Foods to avoid include milk, cheese, dried beans, peas, colas, nuts, and peanut butter

  10. May have 1 serving per day of… Bananas Nectarines Oranges Kiwi Melon (6” x 1” slice) Melons: cantaloupe, honeydew (1/4 of 5” diameter) OJ (1/2 cup) Beans-soy, navy, white (1/2 cup boiled) Potatoes (1/2 cup or 10 French fries Tomato Spinach-cooked (1/2 cup) Yams (1/2 cup) V8 juice salt free (1/2 cup) Tomato Juice (1/2 cup High Potassium Foods

  11. May have 2 servings per day Apple Peach Cherries (1/2 cup) Pear Plums (2) Fruit cocktail (1/2 cup) Apple juice (1/2 cup) Grape juice (1/2 cup) Mixed vegetables (1/2 cup) Nuts: walnuts, almonds, and peanuts (1 ounce) Split peas (1/3 cup boiled) Peanut butter (2 tbsp) Mushrooms (1/2 cup) Okra (1/2 cup) Pineapple juice (1/2 cup) Medium Potassium Foods

  12. May have 3 servings per day Applesauce (1/2 cup) Blackberries (1/2 cup) Blueberries (1/2 cup) Grapes (1/2 cup) Strawberries (1/2 cup) Tangerines (1) Cranberry juice (1 cup) Lemonade (1 cup) Asparagus (4 spears) Green beans (1/2 cup) Bean sprouts (1/2 cup) Cabbage (1/2 cup) Lettuce (1 cup) Onions (1/2 cup) Soaked potatoes (1/2 cup) Cauliflower (1/2 cup) Low Potassium Foods

  13. Too much potassium… • High levels of K+ can cause weakness, numbness, anirregular heartbeat or a heart attack • Foods to avoid include avocados, bananas, kiwis, and dried fruits

  14. Try to limit high sodium foods to one per day… Processed cheese (1 ounce) Bouillon cubes (1/2 cup) Sauerkraut (1/4 cup) Bacon (2 slices) Hot dog (1) Ham (3 ounces) Tuna fish (1/4 cup) Gravy (1/4 cup) Chips – potato, corn, pretzels (1 cup) Soy sauce (1-1/2 tsp) Salt (1/8 tsp) Sodium

  15. Allspice Basil Chili Powder Coriander Dill Cumin Curry Garlic Mustard Onion Sage Tarragon Thyme Parsley Oregano Rosemary Friendly Sodium Substitutions

  16. Too much sodium… • Causes thirst! Drinking too much fluid in response causes the heart to work harder to pump the fluid through the body, and over time can result in high BP and CHF. • Also can cause headaches, puffiness, and shortness of breath. • High Na+ foods to avoid: cured foods, pizza, fast foods, processed foods, frozen dinners, luncheon meats

  17. Protein • Protein is essential for building muscles, repairing tissue, fighting infections • 8-10 ounces of high protein foods everyday (3 ounces = deck of cards, 1 ounce = golf ball) • Protein bars and Prostate help maintain that goal

  18. Not enough protein… • Dialysis filters out protein, and the body will begin to use protein in muscles for fuel (muscle wasting) • Can cause fatigue, weight loss, increased risk of infections, and loss of mental awareness • High quality protein foods include beef, pork, chicken, fish, soy

  19. Eating Out • Plan ahead • Be aware of portion size • Ask for gravy, sauces on the side • Request “no salt” • Ask question to wait staff • Share with family, friends

  20. Eggs – cooked to order Toast, bagel, English muffin, croissant, plain or blueberry muffin Margarine, jelly, honey, sugar and syrup Donuts, Danish pastry, coffee cake Pancakes, waffles, French toast Ham, sausage, or Canadian bacon Biscuits and bran muffins Real maple syrup or gravy Pastries with chocolate, nuts, coconut, or caramel Home fries or hash browns Better choices vs. poor choices

  21. Caesar salad with chicken or shrimp Meat filled tostadas Crab cakes, clams, most shrimp dishes Green salad Coleslaw Pasta salad Cottage cheese or other cheese dishes Quiche, cheese sticks Oysters Salted or smoked meat Potato salad Greek salad with olives Better choices vs. poor choices

  22. Beef Seafood or meat kabobs Sandwiches (no cheese) Fajitas Steamed rice Unsalted breadsticks Mixed dishes, liver and onions Gravy Sub sandwiches Bean dishes, chili beans Fried rice Baked or refried beans Better choices vs. poor choices

  23. Angel food, apple, lemon, pound, white or yellow cake with whipped cream Sugar cookies, butter cookies Strawberry shortcake Pies, tarts or cobblers made with apple, blueberry, cherry, lemon meringue or strawberry Chocolate, carrot, coconut, devil’s food, fruit or German chocolate cake Brownies, coconut macaroons Bananas, oranges or kiwi Pies like banana, chocolate, or coconut cream, pumpkin cheesecake Better choices vs. poor choices

  24. Food labels

  25. Food labels • Listing phosphorus & potassium is not required, and if they aren’t listed, it does not mean they are not in that food item • Understanding the terms: • Sodium Free - Only a trivial amount of sodium per serving. • Very Low Sodium - 35 mg or less per serving. • Low Sodium - 140 mg or less per serving. • Reduced Sodium - Foods in which the level of sodium is reduced by 25%. • Light or Lite in Sodium - Foods in which the sodium is reduced by at least 50%.

  26. Keep in mind… • Low sodium products have added potassium • If sodium is listed among the top 5 ingredients, it means that product contains too much! • Ingredients to Avoid: Banana, cheese, chocolate, cocoa, coconut, cream, dried fruit, dried peas and beans, lentils, melon, milk, molasses, nuts, orange, peanut butter, potassium chloride, potato, raisins, dark rye flour, frozen vegetables packed with sauce, spinach, tomato, wheat or oat bran, whole wheat

  27. Excellent resources • www.kidney.org (National Kidney Foundation) • www.kidneyschool.org • www.kidneyfund.org • www.aakp.org • www.niddk.nih.gov