The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with chronic renal failure?
A. High carbohydrate, high protein
B. High calcium, high potassium, high protein
C. Low protein, low sodium, low potassium
D. Low protein, high potassium
Correct Answer: C. Low protein, low sodium, low potassium
Dietary management for clients with chronic renal failure is usually designed to restrict protein, sodium, and potassium intake. Protein intake is reduced because the kidney can no longer excrete the byproducts of protein metabolism. Reducing sodium in the diet helps to control high blood pressure. It also keeps one from being thirsty and prevents the body from holding onto extra fluid.
Option A: People on dialysis need this special diet to limit the buildup of waste products in the body. Limiting fluids between dialysis treatments is very important because most people on dialysis urinate very little. Without urination, fluid will build up in the body and cause too much fluid in the heart and lungs.
Option B: Too much potassium can build up when the kidneys no longer function well. It can cause an irregular heartbeat or a heart attack. Low-protein diets may be helpful before the client starts dialysis. The provider or dietitian may advise a lower-protein diet based on weight, stage of disease, how much muscle the client has, and other factors.
Option D: Normal blood levels of potassium help keep the heart beating steadily. However, too much potassium can build up when the kidneys no longer function well. Dangerous heart rhythms may result, which can lead to death. Fruits and vegetables contain large amounts of potassium, and for that reason should be avoided to maintain a healthy heart.
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