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  1. #1
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    Default Nutrition for ESRD

    My nephew lost his parents when he was 19. He's currently 24. After becoming homeless he came to live with us about 7 months ago. He was recently hospitalized with a staph infection in his chest cath. and that's when I learned he has ESRD, CHF and severe hypertension. After a month in the hospital he was released to our care again. Now we are taking him to dialysis three times a week at a clinic we located closer to home. I've learned that since his was diagnosed nearly 2 years ago, he has not been compliant with treatment, medication or dialysis. I'm doing all I can to learn what I can do to help him do what he needs to do. One of the biggest issues is ongoing infection to his chest cath. because he failed to have a fistula put in at the doctor's request over a year ago. I will be taking him back to have that done as an outpatient. I tried to have it done before his discharge, but they couldn't risk it due to a staph infection he had in his blood, etc. I thought a diet high in protein would be beneficial to him, while reducing sodium and fluid intake. Now I'm learning that it is not. I'm being told that certain fruits and veggies are also not good for him - but I'm so clueless about his needs that I'm desperately trying to figure all this out. I thought that perhaps upon his discharge they would have had professionals in place to help us with all this - but no such luck. I've yet to have his kidney doctor or cardiologist call me back. So basically I feel like I'm on my own. Several doctors released him from their care because of his failure to comply - so now I'm taking it upon myself to make sure he takes his meds and is driven to and from his treatments. I'm trying to be as involved and informed as possible, but there is just an abundance of information that makes all of this very overwhelming. I recently registered for this forum in the hope of learning, researching and understanding more, but am awaiting the ability to post. In the interim, any information that you can provide to me or resources, links that you can direct me to would be so helpful. Thank you for any assistance you can provide. ~ Krista

  2. #2
    Join Date
    03-15-10
    Location
    Los Angeles, CA
    Posts
    23

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    Dear Krista,

    Thank you for your message. I would like to commend you on taking such an active role in the care of your nephew. The diet for people on dialysis can be difficult to learn and even harder to follow. I am happy to provide you with some general information. However, it is important that the diet is tailored to the needs of your nephew, which depends on multiple factors. The dietitian at the dialysis center should be able to customize the dietary recommendations and provide an eating plan. The diet is based on the current lab results as well as the health of the patient.

    Typically, patients on dialysis need to consume more calories and protein (especially protein from meat, chicken, fish, and egg whites). The nutrients that need to be restricted are phosphorus (found in colas, processed meats, most dairy products, nuts, beans, and any food product that has phosphate or phosphorus in the ingredient list), potassium (found in tomato/tomato sauce, bananas and other tropical fruits, oranges/orange juice, dairy products, among other foods), and sodium. Patients often need to follow a fluid restriction because they do not make much urine. You can speak to the dialysis nurses about your nephew's fluid allowance.

    You can go the the USDA Nutrient Database to find the nutrient content of foods:
    http://www.nal.usda.gov/fnic/foodcomp/search/

    You can refer to www.DaVita.com for resources and recipes for people on dialysis. The dietitian and the social worker at the dialysis center should be helpful at providing you with information and education about things such as diet, kidney transplant, insurance, and the dialysis process.

    Please feel free to reach out if you have any more questions.

    Sincerely,

    LeeAnn Smith Weintraub, MPH, RD

  3. #3
    Join Date
    08-17-04
    Posts
    2,147

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    You might also want to visit our free Kidney School at http://www.kidneyschool.org. Kidney School has 16 modules. One is on Nutrition and Fluids--but you may also want to read through some of the others (like Coping), to see what your nephew is facing. One clinic had a young man about your nephew's age who had adherence issues and they had him visit Kidney School--and found that it helped him to follow his treatment plan. Maybe it will help him, too.

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