Renal Disease and Medical Nutrition Therapy

With the exception of Acute Renal Failure and Chronic Renal Failure in the pre-dialysis state, the nutritional needs of the person with Renal Disease are generally increased, including the need for total calories, dietary protein of high biological value, water soluble vitamins and the minerals iron and calcium. The presence of edema (fluid retention), anuria (lack of urination), oliguria (reduction in urination), or uremia (a complication of acute renal failure), usually necessitates restrictions in fluid intake and dietary sodium, potassium and phosphorus³⁶.

The above situations can easily translate into complicated dietary prescriptions that are often difficult to educate on and to adhere to. Renal disease and treatment, co-morbidities, challenging dietary regimes with varying degrees of compliance and other factors can result in nutritional compromise, manifested in weight loss, muscle wasting, anorexia (lack or appetite), early satiety (feeling of fullness), dysgeusia (taste alterations) and lower biochemical indices, especially pre-albumin³⁷, all of which increase morbidity and mortality.

It is therefore imperative to intervene early and aggressively in this process with nutritional support that includes good quality protein supplementation and micronutrients as needed.

Whey protein is complete protein of the highest biological value. It is naturally low in sodium, potassium and phosphorus and can be mixed with minimal fluids when restriction is needed. It can be made into a high calorie shake to use as a meal replacement or added to foods as needed to increase protein content in the diet.

WHY USE PROTEEM™ WHEY PROTEIN FOR THE PATIENT WITH RENAL DISEASE?

Proteem™ is/provides:

• High quality, complete protein, contains all 9 essential amino acids needed for maintenance/repletion of lean body mass
• Naturally low in sodium, potassium and phosphorus, will not contribute to high serum levels of these minerals, especially if made with water³⁸
• Can be mixed with as little as 4 ounces of liquid, consistent with restricted fluid needs; will not cause early satiety
• Versatile: can be made into a nutritious shake or added to foods, according to the individual calorie and protein needs of this population; will not contribute to taste fatigue
• Good tasting, preferred by VNA renal patients to Ensure/Prostat 64, will not contribute to dysgeusia³⁹
• Mixes well, no clumping

Improved Patient Outcomes using Proteem™ Whey Protein for Renal Patients:

• Increased weight, specifically muscle mass, decreasing risk of morbidity and mortality
• Increased serum pre-albumin, the biochemical maker of choice in this population, indicative of repletion of body protein stores
• Improved quality of life as evidenced by increase in ADLS (activities of daily living) i.e. standing, pivoting, ambulating and mental alertness
• Greater compliance with more consistent usage of product secondary to taste preference and versatility

[ 36 ] Yale New Haven Hospital Diet Manual Table III Renal Diet Guidelines p216-218
[ 37 ] American Family Physician Vol. 65, No.8:1575-1578, April 15, 2002
[ 38 ] Proteem™ contains 52 mg of sodium, 104 mg of potassium and 80 mg of phosphorus in 28 g of product
[ 39 ] Feedback from VNA hemodialysis patients using Proteem™, 2005-2006