Renal Dietetic Therapies

Many patients with Chronic Kidney Disease will spend a period of time in hospital whether you are unwell due to an infection or requiring a fistulae formation. So how can you make sure you are eating well? While in hospital it is very important you maintain a good nutritional intake. Some people may struggle with this. You may find the food is not the same as what you usually eat, you may be experiencing nausea and vomiting, or you could be nil by mouth (that is, not being allowed to eat before a procedure). Whilst you are admitted you will be screened weekly to assess your nutritional status. This will be completed by checking your weight and assessing your appetite.

Should I be following a ‘renal diet ’when in hospital? While you are in hospital it is important to try and eat as normally as possible. This sometimes means following a fluid restriction, or a low potassium diet, if this is usual for you. It is important to know, however, that during a hospital admission you may experience a reduced appetite. This can result in reduced oral intake and weight loss. If this continues for some time, it can lead to malnutrition and put you at greater risk of infection, pressure sores and a longer hospital stay. Eating well really does aid your recovery! The focus whilst you are in hospital is getting enough calories and protein in your diet. If you have a reduced appetite and are struggling to eat all of your meals while in hospital, see our top tips section below.

Top tips

  • Try to eat little and often if your appetite has reduced-you can ask for snacks in between meal times such as biscuits, yoghurts, cakes, cheese and crackers.
  • Try to eat your protein and starchy food first as they provide you with the most energy and protein.
  • Don’t fill up on fruit and vegetables when you have a poor appetite. These are low in calories and protein. When you do eat them, always add butter/sauces or yoghurts and custard to boost the energy and protein content.
  • Always try to have a pudding with each meal – this can increase your daily calorie intake.
  • If you are struggling with a low appetite ask family members/friends to bring in some of your favourite snacks from home. Remember if you are bringing in cold food it needs to be labelled and dated. Unfortunately, food cannot be reheated on the ward.
  • If appropriate, nutritional supplements may be prescribed to you whilst on the ward. These are milk or juice based nutritional drinks that provided additional energy, protein and vitamins.
  • If you have any dietary allergy/intolerances please speak with the housekeeper so we can be sure to provide the right type of food for you.
  • If you are a dialysis patient, remember to keep track of your fluid restriction whilst in hospital. You may be offered drinks more regularly than normal. Be sure to count all liquids as part of your fluid allowance.
  • If you are taking a phosphate binder bring them into hospital with you and ensure you are taking them with each meal (drug rounds are not always at the same time as meals which will affect the absorption of phosphate).

If you have had a kidney transplant you should be given a food safety booklet. If you do not receive this ask one of the transplant nurses for a copy. This will give you information regarding keeping your diet safe after a transplant. Remember if you are concerned and have experienced a large amount of weight loss you can ask the nurses to refer you to a dietitian for extra support.

Keeping active

  • Whilst in hospital we encourage all patients to mobilise (move around) the way they would normally at home, and to ensure they are sitting out of bed as much as possible. Keeping active whilst in hospital is known to have lots of benefits including:
  • maintaining and improving your strength, balance, and independence as well as reducing the risk of picking up chest infections. Kidney disease can often make people feel tired but exercise can help you to feel more energetic because it helps your muscles to become accustomed to activity. Besides physical benefits, exercise can also help to improve your psychological well-being. If your walking is more difficult than usual the nursing staff will be able to assist you with your mobility and transfers. Unless you are told otherwise by your medical team, we strongly advise you to keep mobilising, even if it is more difficult than usual. And we still encourage you to sit out of bed daily.

The nursing staff or your doctor can refer you to the therapy team on the ward if you need more help than usual. The therapy team will be able to advise you on a specific exercise programme to help you to regain and maintain your strength and independence.

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