Sunday, June 17, 2012

Navigating through the Renal Diet

By: Rachel Coury

Ask any dietetic intern what the most difficult diet to counsel patients on is and they'll likely say the renal diet. The reason? It's very restrictive and challenging to navigate through. One of the biggest accomplishments I've had this internship year was learning the ins and outs of the renal diet and counseling patients on how to follow it. The renal diet is a meal plan designed for patients with chronic kidney disease. Because these patient's kidneys are failing, they need to limit their intake of sodium, potassium, phosphorus, and fluid. Patient's on dialysis also need to make sure they are intaking enough protein to meet the increased demand on their bodies. This past week I had the pleasure of spending time in a dialysis clinic. I gained practice in giving patients diet educations, reviewing their lab values, and developing nutrition resources.

One of the problems the dietitian noticed was that during the summer her patient's phosphorus and potassium lab values tended to skyrocket. She also noticed that summer was a time of social gatherings: BBQs, graduation celebrations, cookouts, picnics and many fresh fruits and vegetables are in season. Coincidence? We think not. My partner and I developed a resource on ways for clients to keep their phos and potassium levels in check while still attending these events. During the process we learned many "safe serving sizes" of some cookout foods that are high in these nutrients:

  • Corn on the cob: medium ear (~6 inches long)
  • Beans: 1/3 cup
  • Watermelon: 1 thin slice 
  • Mac and Cheese: 1/3 cup
  • Greens: 1/2 cup (chose collards/mustard greens over spinach/swiss chard)
Hopefully the education and resources we provided will help the patients follow their diet during the summertime. I had a great week at the dialysis clinic and found it to be a rewarding experience. Thanks to lots of practice counseling patients and an amazing preceptor, the renal diet doesn't seem so scary to me anymore. 

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