Medical Nutrition Therapy
Medical Nutrition Therapy FCS 363
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This 6 page Class Notes was uploaded by Delores Kessler on Friday October 23, 2015. The Class Notes belongs to FCS 363 at University of Idaho taught by Staff in Fall. Since its upload, it has received 23 views. For similar materials see /class/227856/fcs-363-university-of-idaho in Family and Consumer Sciences at University of Idaho.
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Date Created: 10/23/15
Authors Candace Clark and Rachael Peterson Fall 2001 Peritoneal Dialysis What is Peritoneal Dialysis Peritoneal dialysis PD is one way to rid the body of urinary waste products There are several ways to do this but the underlying principals are the same In peritoneal dialysis a soft tube called a catheter is used to ll your abdomen with a cleaning solution called dialysate The walls of your abdominal cavity are lined with a membrane called the peritoneum This allows water products and extra uid to pass from your blood into the dialysis solution The dialysate contains a sugar called dextrose that will pull waste into the abdominal cavity These wastes and uids leave your body when the dialysate is drained The used solution is then discarded The process of lling and re lling is called an exchange and lasts about 30 to 40 minutes A typical schedule consists of four exchanges per day The dwell time is the time when the dialysate sits in your abdominal cavity which usually lasts around 4 to 6 hours 1 Why Peritoneal Dialysis By choosing peritoneal dialysis you do not have to be scheduled by the dialysis center and during treatments you can stay in your own home You will have a diet more liberal in salt uids protein and potassium 2 Continuous ambulatory peritoneal dialysis CAPD is the most common type of peritoneal dialysis It needs no machine It can be done in any clean welllit place With CAPD your blood is always being cleaned The dialysate passes from a plastic bag through the catheter and into your abdomen The dialysate stays in your abdomen with the catheter sealed After several hours you drain the solution back into the bag Then you re ll your abdomen with fresh solution through the same catheter 1 Pros 0 You can perform the treatment alone at anytime you choose at any location you choose 0 You do not need a machine for CAPD 2 Cons Disrupts your daily schedule Health professionals are not present You may have to cut back on calories because dialysate is high in sugar You may have a hard time fulfilling the protein requirement 2 Lifestyle issues Financial obligations and time requirements may disrupt your daily life Diet restriction may not allow you to enjoy all of foods you are use to eating 3 Complications and Side Effects Weight gain Low albumin Infection Renal osteodystrophy Edema Cramps Peritonitis 3 Cardiac malfunction 4 Diet Prescription The diet for patients on peritoneal dialysis is usually high in protein because protein is lost in the dialysate Potassium is limited because of cardiac problems that may result when potassium cannot be excreted by the kidneys and serum levels get too high 5 Sodium and uids must be monitored carefully to prevent edema water retention Renal osteodystrophy may result if too much phosphorus is eaten Renal osteodystrophy is a metabolic bone disease that results when the increased phosphorus pulls calcium out of the bones causing weakness and aching 3 Fat cholesterol triglycerides and ber may need to be modi ed based on individual needs 5 The following table provides guidelines on how to calculate dietary needs There is also a sample menu provided to give you some ideas on how to plan your diet Source Manual of Clinical Dietetics Supplements Watersoluble vitamins may be recommended to dialysis patients because they are lost during the treatment Typical vitamin supplements include folic acid vitamin B complex and vitamin C The active form of vitamin D must also be supplemented Other fatsoluble vitamins do not usually need to be supplemented 5 Lab Values Blood values commonly tested for dialysis patients include Sodium Potassium Chloride Total C02 Creatinine Glucose Calcium Phosphorus BUN Uric acid Alkaline phosphatase LDH SGOT Cholesterol Total protein Albumin HCT Serum ferritin and Hepatitis B surface antigen 3 Levels of Zinc Chromium and Magnesium should be monitored 6 Medications Phosphatebinders are commonly taken when using peritoneal dialysis for treatment They are used to prevent phosphorus absorption in the body 7 Recent studies have shown that elevated serum phosphorus levels are associated with increased morbidity and mortality 8 Recombinant Erythropoietin drugs antianemia drugs are also taken to prevent anemia an iron de ciency or blood losses in the gastrointestinal tract 7 Hypertension is commonly seen in renal disease patients so it is important to take antihypertensive drugs 9 Tips on how to plan your diet 0 Use protein powders or egg white powders to increase the protein in the food you are eating Cut your potatoes into cubes and soak them for a couple of hours before cooking Replace salt with lemon juice and herbs and spices such as allspice basil celery seeds chili powder and garlic to avor foods Menu 1 9 References wwwniddkniggovhea tmentperitonealtreamentperitoneahtm Accessed on the World Wide Web on December 10 2001 Methods for Kidney Failure Peritoneal Dialysis WWWmywebmdcomprintingarticlel68051147 Accessed on the World Wide Web December 10 2001 End Stage Renal Disease Choosing a Treatment That s Right For You Mahan LK Escott Stump S Food Nutrition and Diet Therapy 101h ed WB Saunders Company2000847853 Thodis E Passadakis P Vargemezis V and Oreopoulos DG Prevention of catheter related infections in patients on CAPD International Journal of Arti cial Organs 2001 24 671682 Manual of Clinical Dietetics 6Lh ed American Dietetics Association2000455460 Houghton M Medical Nutrition Therapy Notes Fall Semester 20017174 Billion W Clinical Nutrition Case Studies 3rd ed WestWadsworth Publishing Company 1999317321 Sedlacek M Dimaano and Uribarri J Relationship Between Phosphorous anal Creatinine Clearance in Peritoneal Dialysis Clinical Complications Am J of Kidney Diseases 20003610201024 Middleton RA AllmanFarinelli MA Taste Sensitivity Is Altered in Patients with Chronic Renal Failure Receiving Continuous Am bulatory Peritoneal Dialysis J Nut 1999129122125