Question

Case Scenario Juan is a 67 year old male with chronic kidney disease (CKD) stage 4 secondary to hypertension, which was undiagnosed for many years since he had not had regular checks with a medical provider. Family history includes father who died of stroke, and mother with type 2 diabetes currently on oral meds. He was referred for Medical Nutrition Therapy by his nephrologist who has seen him twice so far. The MNT service was approved for coverage based on Medicare guidelines. Patient is married with 1 adult child and 2 grandchildren in the home. Wife prepares most meals, traditional Mexican cuisine and he takes a prepared lunch when on the job as a construction worker. He is struggling to complete his tasks at work due to fatigue. He has not noticed a change in appetite, although some foods don't taste as good. Although he has some missing teeth, he reports that this does not affect his choice of foods or ability to eat. He does experience constipation more frequently. His diet is low in fiber and he indicates that he is more inactive or sedentary now then what just a year ago. Although he had not been accustomed to taking medications, his list now includes a diuretic, anti- hypertensives, statin, and sodium bicarbonate. He says he was advised by his primary care physician to decrease salt in his diet but his wife has struggled to adjust her cooking to restrict use of salt.

Considering his family history, medication use, and the most recent lab values, what are four
important points of advice that you would give to Juan in regards to (non dietary) lifestyle
modification that can improve outcomes for someone with CKD.

Answer 1

Health education (Non-dietary guidelines) for the patient with CKD:

Control Diabetes

Diabetes is the most widely recognized reason for kidney disappointment, where the kidneys never again work. You can help lessen the danger of kidney disappointment by controlling diabetes.

On the off chance that you have diabetes, your NYU Langone specialist may endorse drug to control glucose and prescribe customary glucose observing, a solid eating regimen, and exercise.

Lower Blood Pressure

Hypertension, or hypertension, can add to the movement of kidney disappointment. Hypertension can harm veins in the kidneys, frustrating the organs' capacity to expel waste and abundance liquid from the body. Abundance liquid can, thusly, raise circulatory strain considerably more.

Lose Excess Weight

Overabundance weight or stoutness can prompt hypertension and diabetes. Your PCP or dietitian will assist you with discovering approaches to get in shape securely.

Quit Smoking

Smoking exacerbates CKD. Your primary care physician will go over various plans that will help you effectively quit .

Ordinary Exercise

An activity preparing system can assist you with getting into or keep your physical wellness. This, in blend with other way of life changes, will likewise bring down your danger of coronary conduit malady and gloom . Both of these are regular medical issues for individuals with CKD.