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Why is nutrition important for this patient group?

Nutrition is important for those following a renal specific diet due to the fact that the kidneys are not optimally functioning and therefore not able to get rid of enough waste products and fluids from the blood. Dietary changes can help reduce the build-up of waste products and fluid, and it is very important that the requirements for protein, energy, fluids, vitamins, and minerals are met each day. It is important to try and eat the correct balance of foods to promote good health, help maintain weight and muscle stores, and ensure you have enough energy for day-to-day activities. The renal diet can vary and needs to be individualised depending upon the condition, treatment, blood results, weight, medications and usual dietary intake (likes/dislikes). 

What symptoms are associated with this condition that can cause reduced dietary intake?

People with kidney disease can often experience a reduced appetite and taste changes, which are associated with elevated urea levels. These symptoms often result in a poor dietary intake and unintentional weight loss. 

Fatigue, nausea/vomiting, large tablet burden, and constipation/ bloating are other symptoms and reasons why reduced dietary intake may become an issue with this group. 

What is malnutrition and how can it affect this patient group?

Malnutrition is a serious condition that occurs when a person’s diet does not contain enough nutrients. It is estimated that 30-40% of patients on haemodialysis are at risk of malnutrition. 

Malnutrition can increase the risk of illness or infection and complications of renal disease. It can have an effect upon functional ability, leading to reduced mobility and independence which can significantly impact upon a person’s quality of life. 

How to help prevent and /or manage malnutrition in this patient group?

The following are some examples of ways to manage undernutrition in people following a renal diet: 

  • Food can be offered little and often if a person has a reduced appetite. 5-6 smaller snack type meals may be preferable to 3 larger meals throughout the day. 
  • Use full fat foods and full sugar options (if not diabetic) to help increase energy in the diet. 
  • Include high energy snacks and desserts regularly. 
  • It may be possible to relax some dietary restrictions; this should only be done under the supervision of the dietitian. 

Ways to use Pro-Cal™ powder and/or Pro-Cal shot™ to increase nutritional intake?

  • Sprinkle Pro-Cal powders into casseroles, stews or curries or alternatively stir in 120ml Pro-Cal shot neutral flavour. 
  • Sprinkle Pro-Cal powder into mashed potato and stir well or whisk into egg to make scrambled egg. 
  • Add 120ml Pro-Cal shot neutral to porridge oats and heat gently until thickened. 
  • Sprinkle Pro-Cal powder into custard or rice pudding and stir until dissolved. 

Top Tips to aid dietary intake in this patient group:

  • Batch cook- cook or prepare several meals at once and portion into containers and freeze for times when appetite is poor or energy levels are low. 
  • Take time to plan meals for the week ahead and use recommended renal recipe books to help increase variety of meals/snacks. 
  • Add double cream or crème fraiche to porridge, cereals, sauces, mashed potato and milky puddings. 
  • Freeze oral nutritional supplements as ice cubes/ ice lollies to help relieve a dry mouth. 
  • Aim to take oral nutritional supplements at the end of a meal or between meals. They can also be taken while on dialysis.