3.Alteration in plasma ion concentrations (K+, Ca++, and PO4-)
4.Hypertension
Glomerular disease - answer✔•Leakage of small molecular sized proteins (albumin / bence-jones
proteins) into glomerular filtrate
•Albumin cannot all be reabsorbed by proximal convoluted tubules
•Results in proteinuria
Tubulointerstitial disease - answer✔•complex interplay between factors in the tubular lumen, tubular
epithelial cells, peritubular capillaries, resident and infiltrating interstitial cells, extracellular matrix;
•leads to interstitial *inflammation and fibrosis*
Renal disease - answer✔Renal damage or reduction in GFR that persists for at least 3 months;
•Loss of functional renal mass → hypertrophy of remaining nephrons
•Self-perpetuating nephron loss → Azotemia, Uremia, Death
Staging of Renal Disease - answer✔Stage based on plasma creatinine;
Sub-staging based on Proteinuria and Hypertension
At what stage of renal disease does nutritional intervention start? - answer✔Stage 2;
but *use stage of renal disease as a guide to initiate therapeutic renal diet* - more severe disease
indicates more need for renal diet
Nutritional Intervention Goals - answer✔1) Meet nutrient and energy requirements;
2) Alleviate signs of uremia;
3) Minimize disturbances in Fluids, Electrolytes, Vitamins and Minerals, Acid-base balance;
4) Slow progression of disease
Nutrients of Concern in renal disease - answer✔1) Water;
2) Protein;
3) Minerals - Phosphorus, Potassium, Sodium;
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