Question

Renal Case Study

C.B. is a 55 year-old Caucasian male who was admitted for shunt placement for dialysis. He has applied for disability since the upcoming dialysis will prevent him from meeting all of his work obligations.

Ht. 5’9” Wt; 140#

Gradual weight loss of around 20# over the past 6 months. States he has had problem eating due to anorexia and nausea

BUN and Creatinine high; Potassium and phosphorus elevated; anemia; albumin low

Physical appearance: tired, thin male with obvious muscle wasting and subcutaneous fat loss; 2+ pitting edema at ankles

Social Hx: smokes 1 pack of cigarettes a day; no exercise

Diet Hx: Renal diet

1.Using SGA what is his nutritional status?

2.What are his calorie and protein requirements?

3.What do you think his “renal” diet is?

4.Explain the reason for his anemia and the reason for his low albumin.

5. What will be his calorie and protein requirements post-shunt placement on hemodialysis?

6.What supplements would you recommend?

Answer 1

1. As per SGA scale, Stage C Severely malnutritioned patient as there is severe deficit in the food intake, ongoing weight loss greater than 10%, obvious muscle wasting and loss of subcutaneous fat.

2. He needs high protein diet with full of vegetables, iron rich diet.

3. Renal diet is nothing but a high protein diet like eggs, low fat dairy products, fruits, nuts, chicken, rich in veggies low in potassium, phosphorus, sodium etc.

4. Anemia reason is that kidneys cannot produce erythropoietin which is involved in RBC production, also there will be loss of blood in dialysis patients.

reason for low albumin includes loss of albumin during dialysis and inadequate intake of protein