University of Southern Mindanao

Kabacan, Cotabato

College of Human Ecology & Food Sciences

Nutrition and Dietetics Department
ND 322 – Renal Handbook

Name: Gamit, Kathlene Kaye T.

Date performed: 03-31-22

Part 1.
PROBLEM SOLVING:
Patient Y was diagnosed with renal disease. Consider that the laboratory results,
nutritional status, and clinical findings of the patient with the following data:

Patient’s Medical Records:

Sex: Male
Height: 5’7”
ABW = 52 kg
DBW = 64 kg
Nutritional Status = Mild Underweight
PA = 35
NPC = 3 kcal/g
Creatinine clearance = 15 ml/min
Sodium = 70 mEg/liter
Potassium = 30 mEq/liter
Phosphorus = 50 mg/dl
Calcium = 7.0 md/dl
Fluid = 500 ml

Show your Solutions:

 Calculate the protein level.
 Calculate the TER.
 Calculate the Non-protein calories.
 Caloric distribution
o CHO = 70
o Fat = 30
 Dx.
 Dx Translation
 Compute the additional oral fluid.
 Additional sodium required if necessary.
 Additional calcium required if necessary.
 Compute for the total Dx allowances.
 Design a meal plan for one day.
 Evaluate the meal plan must coincide with the Dx allowances.
 DBW = H (m2) x 22
a. 5’7’’ = 5 ft x 12 in + 67 inch
= 67 inch x 0.0254 = 1.7018
= (1.7018)2 x 22
= 2.89612324 x 22
= 63.71 or 64 kg

Nutritional Status
% IBW = CBW / DBW x 100%
= 52 kg / 64 kg x 100%
= 0.8125 x 100%
= 81.25% (mild underweight)

Protein Level
gCHON = Creatinine x clearance x DBW
= 0.45 g x 64 kg
= 28.8 g 0r 29 g

TER = DBW x PAL

= 64 kg x 35 kcal/kg
= 2,240 or 2,250 kcal

Non-Protein Calories
Protein Calories = Chon level x 4 kcal/g
= 29 x 4 kcal/g
= 116 kcal

NPC = TER – Protein Calories

= 2,250 kcal – 116 kcal
= 2,134 kcal

Calorie Distribution
70% CHO, 30% FAT

70% (2,134) = 1,493.8 kcal ÷ 4 kcal/g

CHO= 373.45 g or 373 g

30% (2,134) = 640.2 kcal ÷ 9 kcal/g

FAT= 71.1 g or 71 g

Dx: 2,250 kcal, 373g, 29g, 71g

 Dx = 2,250 C373 P29 F71
= 2000 mg Na (87 meq)1
= 2500 mg K (128 meq)1
= 2300 mg Ca (115 meq)1
= 1000 mg P (65 meq)1

Diet Rx = 2,250 C373 P29 F71

2000 mg (87 meq) Na
2500 mg (128 meq) K
2300 mg (115 meq) Ca
1000 mg (65 meq) P
500 ml fluid

HBV Protein = 2/3 (29) 19g

LBV Protein = 1/3 (29) 10g
= ¼ (29) 7g

3. HIGH BIOLOGICAL VALUE

Food Group No. of CHON Na K Ca P Fluid CHO Fat
Ex (g) (mg) (mg) (mg) (mg) (g) (g) (g)

Milk 1 8 160 400 360 250 141 12 10

Meat 1½ 16 - - - - - - -
Sub-group 1½ - 60 200 60 115 40 - 6
B.3
TOTAL 20 250 700 450 201 145.5 12 11.5

4. LOW BIOLOGICAL VALUE

Food Group No. of CHON Na K Ca P Fluid CHO Fat

Ex (g) (mg) (mg) (mg) (mg) (g) (g) (g)

Vegetable A 1 0.5 2.0 60 15 15 30 3 -

Vegetable B 2 1.2 16 220 60 20 60 6 -
Sub-group
B.1
Rice 4 8 - - - - - 92 -
Group A 1 - 2 60 15 35 75 - -
Group B 3 - 690 180 60 105 30 - -
TOTAL 9.7 710 520 150 175 195 101 -
TOTAL 3 & 4 20.7 960 1220 600 597.5 396 113 11.5
 5.

Food Group No. of CHON Na K Ca P Fluid CHO Fat

Ex (g) (mg) (mg) (mg) (mg) (g) (g) (g)

Fruits 3 - - - - - - - -
A 3 1.2 6 240 20 20 144 30 -
Sugar 15 - 105 300 225 300 30 75 -
Free Foods 32 - - - - - - 160 -
TOTAL 1.2 111 540 245 320 174 265 -

6.

Food Group No. of CHON Na K Ca P Fluid CHO Fat

Ex (g) (mg) (mg) (mg) (mg) (g) (g) (g)

FAT A 5 - 320 16 8 8 8 - 25
FAT B ½ 0.5 9 22 4 10 9 - 5
Free Foods 6 - - - - - - -
TOTAL 0.5 329 38 12 18 17 - 60
TOTAL 3, 4 , 5 31.4 1400 1798 857 935.5 587 378 71.5
,6

G. Compute the additional oral fluid

Fluid prescription 500 ml

Inherent Fluid -587 ml
________
Additional oral fluid 87 ml

H. Additional sodium required if necessary.

Sodium prescription 2000 mg

Inherent sodium -1400 mg
________
Additional oral fluid 600mg

I. Additional calcium required if necessary

Calcium prescription 2300 mg

Inherent calcium -857 mg
________
Additional Oral fluid 1443 mg
  Compute for the total Dx Allowances

ITEM FOOD GROUP LIST NO OF EX.

I Vegetable A 1
Vegetable B.1 2
II Fruit 3
III Milk 1
IV Rice A 1
Rice B 3
V Meat sub group B3 1½
VI Fat A 5
Fat B ½
VII Sugar 15
VII Free Foods
Fat 6

 Design a meal plan for one day

Food Items No. # of ex Amount

Breakfast:
Saging, Lakatan 1 1 small – 10 x3 cm

Pandesal 2 4 pcs
Milk, powder 1 4 tbsp
Sugar, White 3 3 tsp
AM Snack:
Pakwan 2 2 slices
Soft drinks (Cola) 6 18 tablespoon
Lunch:
Rice, boiled 1 ½ cup
Hipon, puti 1 ½ cup
Butter 2 2 tsp
Pipino 1 ½ cup raw
PM Snack:
Saging, Saba 1 1 small
Margarine 2 2 tsp
Tea with Sugar 3 3 tsp
Dinner:
Rice, boiled 1 ½ cup
Pork Tadyang ½ ½ pc
Alugbati 2 ¼ cup cooked
Avocado 1½ 2 medium
Peanut Brittle 3 1 ½ bar
  Evaluate the meal plan must coincide with the Dx allowances.

Food Items # of Amount Energy CHO CHON FAT Na K (mg) Ca P (mg) Fluid
(kcal) (g) (g) (g) (mg) (mg) (g)
ex
Breakfast:
Saging, Lakatan 1 1 small – 10 x3 cm 40 10 0.4 - 3 120 10 10 48
Pandesal 2 4 pcs 216 46 8 - 460 120 40 70 20
Milk, powder 1 4 tbsp 170 12 8.0 10 160 400 360 250 141
Sugar, White 3 3 tsp 20 5 - - 7 20 15 20 2
TOTAL 446 73 16.4 10 630 660 425 350 211
AM Snack:
Pakwan 2 2 slices 80 20 0.8 - 6 240 20 20 96
Soft drinks 6 18 120 30 - - 42 120 90 120 12
(Cola) tablespoon
TOTAL 200 50 0.8 - 48 360 110 140 108
Lunch:
Rice, boiled 1 ½ cup 100 23 2.0 - 2 60 15 35 75
Hipon, puti 1 ½ cup 41 - 8.0 1 60 200 60 115 40
Butter 2 2 tsp 90 - - 10 80 4 2 - 2
Pipino 1 ½ cup raw 16 3 0.6 - 2 60 15 15 30
TOTAL 247 26 10.6 11 144 324 92 165 147
PM Snack:
Saging, Saba 1 1 small 40 10 0.4 - 3 120 10 10 48
Margarine 2 2 tsp 90 - - 10 80 4 2 - 2
Tea with Sugar 3 3 tsp 20 5 - - 7 20 15 20 2
TOTAL 150 15 0.4 10 90 144 27 30 52
Dinner:
Rice, boiled 1 ½ cup 100 23 2.0 - 2 60 15 35 75
Pork Tadyang ½ ½ pc 20.5 - 4 0.5 30 100 30 57.5 20
Alugbati 2 ¼ cup cooked 32 6 1.2 - 16 220 60 20 60
Avocado 1½ 2 medium 22.5 - 0.5 2.5 9 22 4 10 9
Peanut Brittle 3 1 ½ bar 20 5 - - 7 20 15 20 2
TOTAL 195 34 13 3 64 422 124 142.5 166
TOTAL 1238 198 41.2 34 976 1675 778 827.5 68
4

Part 2.
PROBLEM SOLVING:

1. A patient diagnosed with Chronic Renal Failure (CRF) in Peritoneal Dialysis consumed 3 liters
of 4.25% solution. How many calories are absorbed for the dialysate solution?

Solution:
3 L of 4.25% solution = 3x 42,5 g glucose
= 123.5 g total glucose x 0.80 = 102 g glucose absorbed
= 102 g x 3.7 kcal/g = 377.4 kcal from dialysate solution

2. A patient diagnosed with Chronic Renal Failure (CRF) in Peritoneal Dialysis consumed 2 liters
of 1.5% solution. How many calories are absorbed for the dialysate solution?

Solution:

2L of 1.5 % solution = 2 x 15 glucose

= 30 g total glucose x 0.80 = 24g glucose absorbed
= 24g x 3.7 kcal/g = 88.8 or 89 kcal from dialysate solution

3. A patient diagnosed with Chronic Renal Failure (CRF) in Peritoneal Dialysis consumed 5 liters
of 2.5% solution. How many calories are absorbed for the dialysate solution?

Solution:
5L of 2.5% solution = 5 x 25g glucose
= 125g total glucose x 0.80 = 100g glucose absorbed
= 100g x 3.7 kcal/g = 370 kcal from dialysate solution