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Continued Goals

  • Continue to lose weight
  • Reduce calorie intake (lower fat)
  • Continue to lower Na intake
  • Take medications consistently
  • Reduce protein intake
  • Increase fruits and veggies
  • Exercise

Follow-Up

Reading nutrition labels to choose foods with less Na

Trouble taking meds consistently

Lower blood pressure

Lower A1C

Lower body weight

Thinking about quitting smoking

Case Study 1: Mr. Blake

(Group2)

Nutrition Intervention

Interventions?

Slow progression of kidney disease by:

  • Decreasing sodium intake (1500mg Na/day)
  • This will help to lower blood pressure
  • Control blood glucose levels (medication and food choices)
  • Limit protein intake to reduce albuminuria, and high GFR, and intraglomerular pressure.

This will improve CKD

Strategy to Reduce Urine Albumin

Decrease blood pressure (lower Na intake)

  • 1500mg/day

Keep blood glucose in normal range (<7% A1C)

How well are Mr. Blake's Kidney's Working?

Hemoglobin A1C: Refers to glycated hemoglobin, reflective of Diabetes

His value: >9%

Normal value: <7%

How well are Mr. Blake's Kidney's Working?

BUN = Blood Urea Nitrogen

His value: 19

Normal: <20mg/dL

Urea nitrogen is what forms when protein breaks down

How well are Mr. Blake's Kidney's Working?

Medications

  • UACR (Urine Albumin-to-Creatinine Ratio): measures kidney damage

His value: 3894

Normal: <30

Interpretation: high (>300), indicates CKD (chronic kidney disease)

  • eGFR (estimated glomerular filtration rate)

His value: >60mg/g

Normal: >60mg/g

Interpretation: CKD may be present bc >30mg/g eGFR

Nutrition History

Glyburide - blood glucose control in Type 2 Diabetics

Metformin - blood glucose control in Type 2 Diabetics

Fosinopril -HTN

Lovastatin - cholesterol

Baby aspirin - CVD risk

Ranitidine - ulcers

Reno-protective: glyburide, metformin, fosinopril

Allen Blake

3,712 kcals/day

6,109 mg/Na/day

157g/fat (38% of kcals)

97g/protein (10.5% of kcals), 88 g is recommended

397g/CHO (42% of kcals)

3-4 beers on Friday and Saturday nights

Doesn't eat breakfast or lunch (snacks)

Doesn't like to cook

Male, 36 years

Type 2 Diabetic

Albuminuria

Kidney Damage

HTN-140/83 & blood pressure meds

Smoker

Class 2 Obesity (BMI = 36.9)

Edema in left leg

Ulcer on left foot

Lives alone

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