Patient Education

Treatment for ESRD (End Stage Renal Disease) Patient Education

Treatment for ESRD
Treatment for patients who have been diagnosed with renal failure or stage renal disease often include renal replacement therapy, which is also know as dialysis, to take over the function of their kidneys which are no longer working properly. read more...
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Foods low and high in potassium

Foods low and high in potassium
Grapefruits, Carrots, Strawberries, Cucumbers, Avocado, Kiwi, and read more...
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Food sources high in IRON for dialysis patience

High iron, low potassium
Turnip Greens, Lean Veal, Strawberries, Apple Juice, Green Peas, and read more...
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Iron Rich Foods and Potassium Containing Foods

Iron rich foods
Egg Bagel, Peanuts, Almonds, Pumpkin Seeds, Trout and read more...
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Limit your intake of fruit

Limit your intake of fruit
Limit your intake of fruit, vegetables and juices to 4-5 servings each day and read more...
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Salt Lovers - don't despair!

Sodium Sense
Add flavor without salt. Herbs and spices can add a tasteful alternative and give food new zest and read more...
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Why worry about sugar?

Tips to reduce sugar in the diet
Sugars are a simple form of carbohydrate found in at least 21 different forms and read more....
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FOODS LOW AND HIGH IN POTASSIUM

LOW POTASSIUM

FRUITS

  • APPLES (SAUCE & JUICE)
  • APRICOTS (NECTAR)
  • BLUEBERRIES
  • CHERRIES
  • CRANBERRIES (JUICE)
  • FRUIT COCKTAIL
  • GRAPEFRUIT (SECTIONS, ½ FRESH)
  • GRAPES (JUICE)
  • LEMON OR LIME
  • MANDARIN ORANGES
  • PEACHES (CANNED, NECTAR, FRESH - SMALL 2" METER
  • PEARS (CANNED, NECTAR)
  • PINEAPPLE (JUICE)
  • PLUMS
  • RASPBERRIES
  • STRAWBERRIES
  • TANGERINE
  • WATERMELON

VEGETABLES

  • ALFALFA SPROUTS
  • BEAN, GREEN & WAX
  • BEAN SPROUTS
  • CABBAGE
  • CARROTS
  • CAULIFLOWER
  • CELERY
  • CORN
  • CUCUMBER
  • EGGPLANT
  • GREEN PEAS
  • GREEN PEPPER
  • LEEKS
  • LETTUCE (ICEBERG, ENDIVE, ESCAROLE, ROMAINE)
  • MUSHROOMS (CANNED, FRESH)
  • ONIONS
  • RHUBARB
  • SNOW PEAS
  • SPINACH, CHARD (RAW)
  • SQUASH, SUMMER, ZUCCHINI
  • TOMATO:
    1. ½ SMALL
    2. ½ CUP CANNED
    3. ¼ CUP SAUCE
  • TURNIPS
  • WATER CHESTNUTS

HIGH POTASSIUM

FRUITS

  • AVOCADO
  • BANANA
  • CANTALOUPE
  • GRAPEFRUIT JUICE
  • HONEYDEW
  • KIWI
  • NECTARINE
  • ORANGES (JUICE)
  • PEARS, FRESH
  • PRUNES (JUICE)
  • TOMATO OR V-8 JUICE

DRIED FRUITS

  • APRICOTS
  • DATES
  • FIGS
  • PRUNES
  • RAISINS

VEGETABLES

  • ARTICHOKES
  • ASPARAGUS
  • BAKED BEANS
  • BUTTER BEANS
  • KIDNEY BEANS
  • LIMA BEANS
  • NAVY BEANS
  • PINTO BEANS
  • SOY BEANS
  • BLACK EYED PEAS
  • CHICK PEAS
  • SPLIT PEAS
  • BEETS
  • BROCCOLI
  • BRUSSELS SPROUTS
  • GREENS
  • KALE
  • LENTILS
  • POTATOES
  • PUMPKIN
  • SPINACH, CHARD (COOKED)
  • SQUASH, WINTER TYPE:
    • (CORN OR BUTTERNUT)
  • SWEET POTATOES

FOOD SOURCES HIGH IN IRON FOR DIALYSIS PATIENTS!

LOW IN POTASSIUM

FOODS CONTAINING 2 TO 4 MG OF IRON PER SERVING

Lean pork 3 oz 276mg K
Lean veal 3 oz 189mg K
Lean beef 3 oz 195mg K
Frozen mustard greens ½ cup 154mg K
Turnip greens ½ cup 123mg K
Turnip greens 1 cup 216mg K

FOODS CONTAINING 1 TO 2 MG OF IRON PER SERVING

Eggs 1 65mg K
Kale ½ cup 122mg K
Blackberries ½ cup 140mg K
Strawberries ½ cup 143mg K
Apple juice ½ cup 125mg K
Oatmeal ½ cup 73mg K
Enriched bread 1 slice 29mg K

HIGH IRON READY TO EAT CEREALS!

NOTE: CEREALS GENERALLY CONTAIN 30-5
MG OF IRON PER SERVING: ONE OUNCE OF THE FOLLOWING CEREALS CONTAINS 100% OR MORE OF THE MINIMUM DAILY REQUIREMENTS (10-15MG) OF IRON FOR CHILDREN AND ADULTS:

GENERAL MILLS:

Buckwheats 1 cup
Kabooms 1 cup
Total ¼ cups

KELLOGG'S:

40% Bran Flakes ¾ cup
Product 19 1 cup
Raisin Bran ½ cup

POST:

Cinnamon Raisin Bran ½ cup
Fortified Oat Flakes ⅔ cup
40% Bran Flakes ½ cup
Raisin Bran ½ cup

QUAKER:

King Vitamin ¾ cup

RALSTON PURINA:

Wheat Chex ¾ cup

HINT: VITAMIN C (60 mg) TAKEN WITH ORAL IRON FOODS
ENHANCE THE ABSORPTION OF THE IRON


IRON RICH FOODS

  • Egg Bagel
  • Homemade
  • Submarine Roll
  • Instant Breakfast
  • Blackberry Juice
  • Canned Cherries
  • Mango
  • Prunes
  • Prune Juice
  • Raisins
  • Shellfish
  • Trout
  • Beef
  • Lamb
  • Liver
  • Venison
  • Dark Chicken
  • Gingerbread
  • Black Beans
  • Great Northern Beans
  • Lima Beans
  • Amaranth
  • Barley
  • Malt-o-Meal
  • Instant Oatmeal
  • Masa Harina
  • Enriched Noodles
  • Oat Bran
  • Quinoa
  • Liver
  • Soy Flour
  • Wheat Germ
  • Dark Turkey Almonds
  • Brazil Nuts
  • Cashews
  • Filberts
  • Macadamia Nuts
  • Peanuts
  • Pistachios
  • Pumpkin Seeds
  • Sunflower Seeds
  • Roasted Soy Beans
  • Baking Chocolate
  • Cocoa Powder
  • Molasses

POTASSIUM CONTAINING FOODS

HIGH
500mg or more per serving

  • Avocado
  • Walnuts
  • Navy Beans
  • Filberts
  • Orange Juice
  • Prunes
  • Prune Juice
  • Cantaloupe
  • Plantain
  • Raisins
  • Lobster
  • Oysters
  • Salmon
  • Almonds
  • Pistachios
  • Lima Beans
  • Bananas
  • Pinto Beans
  • Kidney Beans
  • Parsnips
  • Black-Eyed-Peas
  • Mashed Potatoes
  • Winter Squash
  • Tomatoes
  • Black Strap Molasses
  • Peanuts
  • Cashews

LOW
100mg or less per serving

  • Bread and Cereal
  • Pasta
  • Cranberries
  • Frozen Grape Juice
  • Canned Pears, Drained
  • Canned Peaches, Drained
  • Plums
  • Poppy Seeds
  • Bean Sprouts
  • Cucumbers
  • Lettuce
  • Radishes
  • Caramel Candy
  • Chocolate
  • Flavored Gelatin
  • Pickles

LIMIT YOUR INTAKE OF FRUITS

LIMIT YOUR INTAKE OF FRUIT, VEGETABLES AND JUICES TO 4-5 SERVINGS EACH DAY.

**ONE SERVING = ½ OR SMALL PIECE OF FRUIT**

LIMIT YOUR INTAKE OF MILK AND DAIRY PRODUCTS TO ½ EACH DAY.

POTATOES ARE HIGH IN POTASSIUM. PREPARE THEM THIS WAY:

  1. PEEL AND CUT INTO SMALL SLICES OR CUBES
  2. PLACE IN A LARGE POT OR BOWL AND FILL WITH LARGE AMOUNT OF WATER
  3. SOAK POTATOES AT LEAST 2 HOURS. (OVERNIGHT IS OKAY)
  4. DRAIN AND RINSE THE POTATOES
  5. BOIL THE POTATOES IN A LARGE AMOUNT OF NEW WATER
  6. DRAIN AND PREPARE YOUR FAVORITE WAY (MASHED, FRIED, POTATO SALAD, ETC.)

POTASSIUM IS A MINERAL FOUND IN MANY OF THE FOODS YOU EAT. IT PLAYS A ROLE IN KEEPING YOUR HEARTBEAT REGULAR AND YOUR MUSCLES WORKING RIGHT. THE KIDNEYS HELP TO KEEP THE RIGHT AMOUNT OF POTASSIUM IN YOUR BODY. HOWEVER, WHEN YOUR KIDNEYS NO LONGER WORK WELL, YOU MUST WATCH THE AMOUNT OF POTASSIUM IN YOUR DIET. EATING TOO MUCH OR TOO LITTLE POTASSIUM CAN BE VERY DANGEROUS TO YOUR HEART!


SODIUM SENSE

  1. Check labels to see if salt or sodium compounds are added. Learn to recognize ingredients that contain sodium. Any ingredient with sodium or soda as part of its name contains sodium.
  2. Season foods with lemon juice, onion and garlic powders (not salts) and herbs and spices (including pepper) instead of salt.
  3. Check with a doctor or registered dietitian before using salt substitute. Most salt substitutes contain potassium salts that are not suitable for some people.
  4. Whenever, possible, choose fresh vegetables, since most canned and some frozen vegetables contain salt. Never salt the cooking water for vegetables or other foods.
  5. Use the salt shaker sparingly. Taste foods first.

ADD NEW FLAVORS TO FOODS

Add flavor without salt. Herbs and spices can provide a tasteful alternative and give food new zest. To replace salt, try one or more of the following:

  • Basil, Marjoram, Saffron
  • Bay leaf, Mint, Sage
  • Celery seed, Nutmeg, Savory
  • Cumin, Oregano, Tarragon
  • Dill weed, Paprika, Thyme
  • Garlic, Rosemary

SALT LOVERS ?? SPAIR!

You were not born with a preference for salt. You learned it, and this means that you can unlearn it by gradually lowering the amount of salt in your diet. Studies show that people who slowly reduce the amount of salt they eat lose their desire for the salty taste.

LOWER SODIUM DEFINITIONS

For those who need to cut back their sodium intake, the Food and Drug Administration (FDA) requires that processed foods with nutrition information tell how much sodium they contain per serving. Here is the FDA?w glossary of lower sodium terms that manufacturers can use when they make a sodium claim:

  • SODIUM FREE: Less than 5 mg per serving
  • VERY LOW SODIUM: 35 mg or less per serving
  • LOW SODIUM: 140 mg or less per serving
  • REDUCED SODIUM: At least 75% reduction in the usual sodium level

TIPS TO REDUCE SUGAR IN THE DIET

WHY WORRY ABOUT SUGAR?

Claims have been made that eating too much sugar increases the risk of obesity, diabetes, and dental caries (cavities), and may cause behavioral problems like hyperactivity. However, the only health problem directly linked to sugar is tooth decay.

WHAT IS SUGAR?

Sugars are a simple form of carbohydrate found in at least 21 different forms. Sugars are widespread in nature, occurring in fruits, vegetables, nectar, honey, legumes, cereals and milk. Sugar is often added to foods. These added sweeteners such as sucrose and corn syrups provide most of the sugar in the average diet. You are probably most familiar with sucrose, white table sugar.

Sugar is a source of calories and carbohydrates but contains few other nutrients. A diet with large amounts of added sugar should be avoided because it may keep you from eating more nutritious foods. This is especially true for people with low calorie needs; persons on weight reducing diets, and the elderly.

HOW MUCH SUGAR IS IN THE FOODS YOU EAT?

The trade-offs below are equations that show approximately how much sugar is added to some popular foods. Foods on each side of the equation provide about the same amount of nutrients. For example, milk and grain based desserts provide he same nutrients as the enriched flour or milk from which they are made, but the also provide much more sugar and fat.

EFFECTS OF FOOD FORM AND PREPARATION

½ patient-ed#zen sweetened fruit = ½ unsweetened fruit + 6 tsp sugar
½ cup fruit, canned in heavy syrup = ½ unsweetened fruit + 4 tsp sugar
½ cup fruit, canned in light syrup = ½ unsweetened fruit + 2 tsp sugar
8 ounces low fat vanilla yogurt = 8 ounces low fat milk + 4 tsp sugar
8 ounces low fat fruit yogurt = 8 ounces low fat milk + 7 tsp sugar
½ cup of ice cream = ⅓ cup skim milk + 2 tsp fat + 3 tsp sugar
½ cup ice milk = ⅓ cup skim milk + 1 tsp fat + 3 tsp sugar
½ cup low fat frozen yogurt = ⅓ cup skim milk + 4 tsp sugar
1⁄16 of white layer cake with chocolate frosting = 1 slice of bread + 3 tsp fat + 6 tsp sugar icing
2 oatmeal cookies = 1 slice of bread + ⅓ tsp fat + 1 tsp sugar
⅙ of 9" apple pie = 1 slice of bread + ⅓ medium apple + 3 tsp Fat + 6 tsp sugar

Treatment for ESRD

Treatment for patients who have been diagnosed with renal failure or end stage renal disease often include renal replacement therapy, which is also known as dialysis, to take over the function of their kidneys which are no longer working properly.

Types of Dialysis Available

Hemodialysis is a process used to remove waste products and fluids from the body. This process replaces some of the functions of the kidney. It is done in an outpatient clinic for 4-5 hours at a time three times per week.

It is necessary to have an access inserted surgically in order to begin hemodialysis treatments. The access is called a fistula or graft and is normally inserted into the arm. For a fistula, the vein and artery are connected together which causes the vein to become larger, eventually becoming like another artery. It takes a process of about 2-3 months for the vein to ?re?become large enough to use for the treatment. A fistula is the preferred access as it uses the patient?n vessels without any artificial material and it will last longer. A graft also connects the artery to the vein but with artificial material. This access requires a healing period of only about 3-4 weeks.

Both of these accesses allow the placement of two needles which are connected to the dialysis machine Through these needles, blood is removed from the patient, goes through the machine and through a filter, and is then returned to the patient.

The other type of renal replacement therapy is peritoneal dialysis which is done at home by the patient or a family member. The access used for this type of dialysis is a catheter which is surgically inserted into the patient?domen. A period of approximately 6 weeks is needed for healing. With this type of dialysis, the abdominal cavity is filled with a solution which stays in the abdomen for about 4 hours. This procedure is done 4-5 times per day. The solution is made up of glucose and electrolytes and pulls waste products, excess electrolytes, and fluid out of the patient?ood. This must be done as a sterile procedure in order to avoid an infection. Patients participate in a training period for approximately 1-2 weeks to learn how to perform the dialysis procedure.

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