Presentation on theme: "SOCIETY OF RENAL NUTRITION AND METABOLISM (SRNM)"— Presentation transcript:
1SOCIETY OF RENAL NUTRITION AND METABOLISM (SRNM) www.srnm.in Kidney Disease Awareness ProgrammeFacts And MythsSOCIETY OF RENAL NUTRITION AND METABOLISM (SRNM)
2Facts About Renal Disease Renal disease is a complex disease.It does not occur in isolation, rather it is multifactorial.As the disease progresses, it affects other organ systems as well.Kidney disease can cause malnutrition.Appropriate nutritional intervention can prevent malnutrition.
3What Is Chronic Kidney Disease (CKD) ? CKD means kidney damage for 3 or more than 3 months as defined by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR).GFR measures level of kidney function.GFR describes the flow rate of filtered fluid through the kidney.A GFR below 60 for three months or more or a GFR above 60 with kidney damage (marked by high levels of albumin in your urine) indicates chronic kidney disease.
45 Stages of CKD Depending Upon GFR ml/ minute. DescriptionGFR ml/minute1Kidney damage with normal kidney function90 or above2Kidney damage with mild loss of kidney function60-893aMild to moderate loss of kidney function59 to 443bModerate to severe loss of kidney function44 to 304Severe loss of kidney function29-15,5Kidney failure<15
5Ways To Know How Well Your Kidneys Are Functioning? You can calculate kidney function by using the following equation:(140- Age years) x Body Weight (kg)For Men72 x serum creatinineFor Women x0.85Serum creatinine can be known through blood test
6Facts About Renal Disease How will you know you have kidney disease?Symptoms of Kidney diseaseFacial puffinees (swelling)Pedal Edema (Swelling on legs and feet)Loss of appetiteWeight lossSwelling over body.Reduced urine output, difficulty in passing urine.Malignant hypertension (high blood pressure) in young individualsUnexplained fatigue which develops due to low hemoglobin (anemia)or ongoing silent infection.Patients of kidney disease have low hemoglobin as sick kidney cannotmake enough hormone which is required for formation of blood.Loss of hair, sensitivity to sun rays, bony pains, unexplained rashes onface and nose, frothy urine (presence of protein in urine),
7Simple Tests For Kidney Disease? Kidney function is assessed through blood test and urine test1. Blood test:Serum creatinineBUNSodiumPotassiumCalciumPhosphorus2. Routine urine test: presence of protein
8What Causes Kidney Disease? There are several causes of kidney disease.1. High Blood pressure can cause kidney disease.
9High Blood PressurePatients who have High Blood Pressure shouldRestrict salt intake. High salt intake can cause hardening of blood vessels.Avoid fried food.Fats increase cholesterol and triglycerides which causes plaque (blockages in blood vessels) formation. Plaques can hinder blood supply to organs .Eggs are good. But egg yolk is rich in cholesterol, therefore, it is not good for patients with high blood pressure and kidney disease. Patient of kidney disease can eat egg white (albumin) if doctor advises.Patient should take blood pressure medication on time. If you are forgetful, set alarm on your mobile to remind you of your medication time.Blood pressure medications can be taken empty stomach.
10What Causes Kidney Disease? ….. Contd. 2. Diabetes can cause kidney disease.Keep your blood sugar under control.Regular exercise like walking and cycling can help in controlling sugar.Diet is an important way of controlling blood sugar.Keep your meal time fixed.Do not skip meals. Diabetic patients must have routine checkup of kidneyfunction (serum creatinine) and presence of proteinuria.Patients with deranged renal function should avoid metformin (oralhypoglycemic medication)
11What Causes Kidney Disease?.... Contd. 4. Painkiller (like ibuprofen, NSAIDs, aspirin ) and Aminoglycosideantibiotics can also cause kidney disease.5. Excessive loss of fluid from body due to diarrhoea and vomiting canbring blood pressure down and affect blood supply of kidneys andkidneys can stop making urine.6. Excessive blood loss after delivery can also lead to kidney failure.Kidneys can stop making urine. Avoid delivering baby at home.7. Venoms (wasp sting, snake poisons) can cause kidney failure.
12C) What Should Patient Of Kidney Disease Eat? Kidney Disease Patient should not eat food items which are high in potassium, sodium and phosphorus. Fruits: a) All Fruits are not good for kidney patient. Fruits like anar (pomegranate), malta, musammi (sweet lime), cheeku, tarbooz, kharbooja, , lemon, mango should not be eaten by kidney patients. These have high potassium content. b) Patient with kidney disease can eat apple, banana, papaya, orange, pineapple and pear if serum potassium is below 5.0 mg/dl. c) Fruit juice, vegetable juice and vegetable soup, coconut water are harmful for the kidney patient.
13VegetablesA) Avoid leafy vegetables like spinach (palak), mustard (sarson), chaulai,cauliflower (gobhi), brinjal (baingan), Bitter gourd (karela), tomatoes,carrots, raw salad,and dry fruits.B) Patients can eat Parval, lauki, turai, green Peas, bhindi (ladies finger),potato, tinda
14Take Low Potassium Fruits High serum K+ Can cause arrhythmiaTake low potassium fruits if serumpotassium is <5.0mg/dlApple, banana, guava, pear, orange, papaya
15Is it possible to remove potassium from vegetables? Yes it is possible to remove (leach) potassium from vegetables by doing the following: 1. Soak chopped vegetables in Luke warm water for half an hour or 2. Boil chopped vegetables in water. Discard water and then cook. Leaching process can be used before cooking dal (pulses).
16Reduce Potassium Content Of Vegetables Leach/remove potassium from vegetables by soaking chopped vegetables in luke warm water for half an hour. Kidney Patients should refrain from eating green leafy vegetables, tomatoes, cauliflower sweet lime, lemon, carrots, raw salad, mango, dry fruits, fruit juice, vegetable soup, coconut water.
17What Should Patient Of Kidney Disease Avoid? Avoid canned Foods/Fruits/Pickles/fruit jamCanned foods and pickles have salt as preservative. Fruit jam is high in potassium.Restrict salt: 1 tsp of salt is equal to 5g of salt. 5 g of salt contains 2.5 g of sodium. Patient should not take more than 2.4 g of sodium for better control of blood pressure and to prevent edema.Restrict Oil: Patient should not consume more than g (3-4 tea spoons) of refined/mustard oil in a day.
18Sodium intake in CKD <2 Sodium intake in CKD <2.4 g/d (AHA/KDOQI Guidelines for control of Hypertension) 1 tsp=5g =2.5 g Na Low Sodium Diet for Renal Patients for better control of blood pressure and to prevent edema Avoid Foods containing Sodium>100 mg/100g Avoid canned foods/fruits/Pickles/fruit jam
19Should Patient With Kidney Disease Eat Food Containing Protein? Yes. Patient of kidney disease should eat low amount of protein.To calculate protein intake /day here is an example.Protein intake = weight x 0.7g/kg/dA patient who has 50 kg of weight can take 35 grams (0.7g x body weight in kg ) of protein in one day.He can take 1 bowl of dal (neither very thin nor very thick), 150 ml of milk and 100 grams of curd.Rest of protein will be consumed in bread slice, chapatti and rice.If a patient is on maintenance dialysis, protein intake should be increased to 1.2g/kg/day.
20Do Not Eliminate Protein From Diet. Kidney Patient should take Low Protein 0.6g/kg/d Example: Weight of patient = 50 kg 50 x 0.6 = 30 g of protein 1. Milk 150 ml = 4.5 g/protein 2. Dal 1 bowl = 6 g protein 3. Chappati=2 g 8 chappaties = 12 g 4. Rice: 50 g raw = 3 g Total Protein Content = 25.5g1234
21Patient should not stop eating protein completely otherwise body muscles will break down and the patient will become malnourished.Malnutrition is an important challenge in kidney disease. It sets in silently causing patient’s Physical condition to deteriorateover time.Patient will have Progressive weight loss Wasting of fat and skeletal muscle tissues Reduction of serum proteins.
22Myths1. Myths about low sodium salt These are high in potassium. Warning : High potassium is not meant for patients with kidney disease. This can be bad for heart. 2. Myth Drink a lot of water- Patients with kidney disease should restrict water intake. Water intake will depend on how much urine the patient is making. Ask your doctor how much water you should drink. Too much of water intake can cause edema (swelling) when kidneys are diseased. The kidneys will not be able to remove water from the body.
23Are All Patients Alike? No every patient is different. For example If a patient has kidney stone disease then he is advised to take more fluids because patient with kidney disease should not have concentrated urine as this will precipitate stone formation. Patient should make at least 2 liters of urine/day. For this fluid intake will have to be two or more than 2 liters/day. Do not follow what other patients advise you. Follow your own doctor's advise. As soon as one comes to know that he has kidney disease, he should see anephrologist (kidney specialist).
24Your Cooperation Can Help Fight Malnutrition In Kidney Patients Your Cooperation Can Help Fight Malnutrition In Kidney PatientsKIDNEY DISEASE MALNUTRITIONDIALYSISFor More Information ContactOfficial Address of SRNM: Secretary SRNM, Department Of Nephrology, SGPGIMS, LucknowPresident SRNM, Department of Nephrology, Sir Ganga Ram Hospital, New Delhi