Nutritional Management of...

A 26-year-old female patient weighing 77 kg with a height of 152 cm and a BMI of 33.33 kg/m2 was admitted to the clinic of nephrology presenting symptoms including anorexia, edema, dyspnea, pruritus, and urinary retention. Her medical history revealed a background of renal insufficiency, hypertension, and type 2 diabetes mellitus. The patient was diagnosed with stage 5 Chronic Kidney Disease (CKD) and was scheduled to commence hemodialysis. The CKD was attributed to untreated diabetes mellitus and manifested with glomerular wall damage, increased perfusion, loss of protein, edema, metabolic acidosis, uremia, azotemia, hyperphosphatemia, hyperkalemia, oliguria, and hypertension. Despite experiencing poor appetite, the patient had recently gained 4 kg in weight. In the last 24 hours, her dietary intake consisted of toast and a carbonated beverage for breakfast, a cheese sandwich with a chilled beverage for lunch, and a serving of vermicelli with iced tea for dinner. Her current pharmacotherapy is comprised of captopril, calcitriol, erythropoietin, vitamin and mineral supplements, and glucophage.1