DIET THERAPY: FOOD LISTS AND MEAL PLANS IN RENAL FAILURE

DIET THERAPY: FOOD LISTS AND MEAL PLANS IN RENAL FAILURE
A protein-free electrolyte-free diet may be used for a few days if the patient is anuric. This supplies sufficient calories to prevent tissue breakdown. Calories are furnished by hard candies and butter balls consisting of a mixture of butter and sugar flavored to improve palatability. A number of high-carbohydrate supplements that contain no protein or electrolytes are commercially available.
Sources of protein. Almost all of the protein in the restricted diets must come from milk, eggs, and meat. Cereals, bread, rice, macaroni, spaghetti, and noodles are usually depended upon as good sources of calories. However, 6 to 8 servings of these foods a day would account for 15 to 25 gm protein, which is not of high biologic value. Obviously not much of these foods could be used on diets restricted to 40 gm protein or less.
Special flours and breads have been developed by food processors that are protein-free and low in potassium and sodium. Recipes for using these products have been developed by the manufacturers. The absence of protein in the flour means that breads will not have the texture qualities provided by gluten, and they are generally less acceptable to the patient. Jellies, unsalted butter and margarine, and honey improve the palatability as well as enhancing the caloric intake. The nurse must emphasize to the patient that it is important to consume all the food allowed on the diet; it is not sufficient to restrict protein alone.
Sources of potassium. The normal intake of potassium varies from 3000 to 8000 mg, being at the higher levels when protein and calorie intakes are high. Protein-rich foods are also good sources of potassium. Therefore, diets restricted in protein will also contain less potassium.
Potassium salts are quite soluble in water. Stewed meats will have less potassium than broiled or roasted meats, providing that the stewing liquid is not consumed.
Vegetables and fruits are also good sources of potassium, but there is a wide variability from one food to another. Canned fruits and vegetables contain less potassium than fresh if the liquid is drained from the product. Boiled potatoes will have less potassium than baked or fried potatoes. The potassium content of a potato can be reduced by (1) cutting the potato into small pieces, (2) immersing the potato in water for 1/2 hour before cooking, and (3) boiling in fresh water to cover.
Sources of phosphorus. Milk, eggs, meat, poultry, fish, nuts, whole-grain breads and cereals, dried beans and peas, dried fruits, chocolate, and cocoa are rich sources of phosphorus. When the diet is restricted in phosphorus controlled amounts of milk, eggs, meat, fish, and poultry are allowed. Enriched bread or low-protein bread may be used.
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GENERAL HEALTH

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