The typical dietary plan for a patient with acute kidney injury would focus on provision of:
1. High fat, low protein
2. High carbohydrate, low protein
3. High protein, low sodium
4. High calorie, low carbohydrate
2
Rationale 1: A high-fat diet is not healthy for any patient population. A low-protein diet is not appropriate as this would cause the body to break down lean muscle mass for metabolic function.
Rationale 2: Goals for nutritional intervention in the patient with acute kidney injury include preserving lean body mass, preventing metabolic alterations, and enhancing renal recovery by limiting uremic toxicity. Protein is allowed but limited because its catabolism may result in accumulation of toxic waste products (urea, phosphate, and potassium). Protein requirements can be calculated roughly based on the rise in the patient's BUN in 24 hours, and the amount of protein in the patient's diet can be based on this calculation. The remainder of the calories the patient requires is supplied as carbohydrates or lipids.
Rationale 3: A high-protein diet is not appropriate as this would cause a lethal amount of toxic waste to accumulate in a renal failure patient. A low-sodium diet would be appropriate as this would aid in reducing fluid retention.
Rationale 4: A high-caloric diet is not appropriate for this would contribute to unnecessary weight gain. Carbohydrates are needed for energy so restriction would be detrimental.
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