Transcript Protein Management for Hemodialysis Patients

Protein Management for Hemodialysis Patients
Polly Peru
Chronic Kidney Disease & Hemodialysis
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One in nine American adults is
currently suffering from chronic
kidney disease. Chronic kidney
disease is the eighth leading
cause of death in America.
The two main causes of chronic
kidney disease are diabetes and
high blood pressure, which are
responsible for up to two-thirds
of the cases.
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Polycystic Kidney Disease
Glomerulonephritis
Lupus
Malformations in utero
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The kidneys perform many vital
functions in the body which
include:
filter toxins out of the body
regulate blood pressure,
maintain acid-base balance,
stimulate the bone marrow to
make red blood cells by producing
the hormone erythropoietin (EPO).
Treatments are limited to hemodialysis, peritoneal dialysis and
kidney transplantation . *None of these are a cure for CKD.
Hemodialysis: Renal
Replacement Therapy
Treatments 3-5 times/week
 2-4 Hours
 Side effects
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Why Protein Needs are Higher for Dialysis
Patients
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The renal diet can be very
challenging as it requires strict
adherence to the restriction of
sodium, potassium,
phosphorus, fluid and the
increase of high-quality protein
Dialysis treatments remove
protein waste and amino acids
from the blood resulting in
higher needs of high quality
protein.
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The Kidney Disease Outcomes
Quality Initiative Clinical Practices
Guidelines for nutrition of
hemodialysis patient’s recommends
the following energy and protein
needs:
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Energy: 35 Kcal/Kg body weight per
day
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Protein: 1.2 - 1.3 g/Kg body weight per
day
Albumin
Serum albumin is a widely used
biomarker of nutritional status in
patients with chronic kidney
disease.
What is Albumin?
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Albumin is the most common
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Your renal dietitian will calculate
your protein intake in grams per
day and track your serum albumin
level for optimal health. If you are
on dialysis and have an albumin
level less than 4.0 grams/deciliter
your dialysis team will work with
you to improve your levels.
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Your grams of protein per day
protein found in the blood.
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Draws extra fluid from swollen
tissues back into the blood, where
it can then be removed during
treatment.
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Provides the body with the protein
are___________.
needed to both maintain growth
and repair tissues.
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Your albumin level
is_____________.
Examples of foods and their protein content to help
you plan your protein intake for the day.
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Meats:
Contain 7 g protein/1-oz
serving or 21 g/3-oz
serving:
Beef (all forms, including
ground beef, steaks, and
roasts)
Pork (all forms, including
ham, loin, chops, ground
pork, bacon, and sausage)
Poultry (all forms, including
chicken, turkey, quail, duck,
goose, and Cornish hen)
Fish (all forms, including
finfish, shellfish, shrimp,
and canned tuna)
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Dairy
Contain 7–8 grams (g)
protein/serving:
1 cup (C) whole, reducedfat, or skim milk
1 C buttermilk
¾ C yogurt
Cheese:
¼ C cottage cheese
2 tablespoons (Tbsp)
grated
Parmesan
1 ounce (oz) feta
1 oz other cheeses
Examples of foods and their protein content to help
you plan your protein intake for the day.
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Meat alternates:
Contain 6- 7 g
protein/serving:
One egg
2 Tbsp peanut butter
½ C dry beans, peas, and
lentils
Soy foods:
1 C soy milk
½ C tofu
¼ C tempeh
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Additional dietary sources
of protein:
About 3–5 g/serving,
serving sizes vary:
Breads: white and whole
wheat, buns , tortillas, naan
and rolls)
Cereals: oatmeal
Grains: grits, flour, and rice
Starchy vegetables: green
peas, potatoes, winter
squash, and corn
Popcorn
Whole Grain Crackers
Nuts and seeds
Nutrition Supplements
Use nutrition supplements
(beverages, bars, etc) as
recommended by your renal
dietitian.
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Add protein powders to warm
or cold liquids such as: hot
cereal, coffee, soup, juices and
smoothies.
Make Wise Protein Food Choices
Taste Test
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Please rate the protein bar samples in the order that you
preferred them.
1 = I liked it
2 = It was ok!
3 = I did not like it
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_______ Luna Lemon Zest
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_______Pure Protein Chocolate Peanut Butter
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_______Balance Bar Peanut Butter
Thank You!