A patient with diabetes mellitus and renal failure begins hemodialysis. Which diet is best on days between dialysis treatments?
A. Low-protein diet with unlimited amounts of water.
B. Low-protein diet with a prescribed amount of water.
C. No protein in the diet and use of a salt substitute
D. No restrictions.
Correct Answer: B. Low-protein diet with a prescribed amount of water
The patient should follow a low-protein diet with a prescribed amount of water. The patient requires some protein to meet metabolic needs. Protein can help keep healthy blood protein levels and improve health. Protein also helps keep the muscles strong, helps wounds heal faster, strengthens the immune system, and helps improve overall health.
Option A: Learn how much fluid you can safely drink (including coffee, tea, water, and any food that is liquid at room temperature). Diet is an important part of the treatment. The kidneys cannot get rid of enough waste products and fluids from the blood and the body now has special needs. Therefore, the client will need to limit fluids and change the intake of certain foods in the diet.
Option C: Salt substitutes shouldn’t be used without a doctor’s order because it may contain potassium, which could make the patient hyperkalemic. Use less salt and eat fewer salty foods: This may help to control blood pressure. It may also help reduce fluid weight gains between dialysis sessions since salt increases thirst and causes the body to retain (or hold on to) fluid.
Option D: Fluid and protein restrictions are needed. At first the kidney and diabetic diet appear to be very different, but they are alike in many ways. Both diets recommend eating 3 balanced meals, avoiding large amounts of protein, and limiting sodium. A balanced meal has at least 3 of the food groups (protein, grain, vegetables, fruits, and dairy). The kidney diet limits the amount of milk that you drink, but many people with diabetes already limit milk to 4 ounces a day.
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