Case Study Patient With Chronic Kidney Disease
Question
James, a 49 year old male, has developed chronic kidney disease as a result of uncontrolled hypertension. James works as a correctional officer and finds his job to be highly stressful. He is aware that he has had hypertension for over 10 years but has never taken measures to treat it. One year ago, James started experiencing headaches and was tired all of the time. He had protein in his urine at that time and was diagnosed with chronic kidney disease. At this time most recent visit, James mentions that he has lost weight and is frequently nauseated and that he bleeds very easily.
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The dietitian is reviewing James’ food and fluid intake and notes that his average fluid intake is 3000 mL of water or non-caloric drinks per day. Which recommendation is most appropriate for James regarding fluid intake?
a. James should drink less fluids and try to drink 2000 mL per day.
b. James should restrict his fluid to 1200 mL per day.
c. James should drink an amount equal to his urine output plus 500-1000 mL per day.
d. James can have unrestricted fluids if his urine output is normal.
Expert Answer
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Step 1/3
ANSWER.
James’ kidneys aren’t working correctly since he has chronic kidney disease. The body may begin to accumulate waste products as a result, including too much fluid. In order to avoid issues like edema (swelling), high blood pressure, and heart failure, it is crucial to control fluid consumption. Option (c) would be the best advice for James in terms of fluid intake: James should drink 500–1000 mL more per day than his daily urine production.
Step 2/3
This advice is based on the idea of “fluid balance,” which states that the amount of fluid absorbed and the amount of fluid the body excretes should be equal. James needs to regularly watch his fluid intake because his kidneys might not be able to adequately remove extra fluid from his body. James can maintain a good fluid balance and avoid problems related to excess fluid by consuming an amount each day equal to his urine output plus 500–1000 mL. James should speak with his medical team for specific advice because this recommendation may need to be modified based on his unique needs and health situation.
Step 3/3
Option (a) is not advised since excessive fluid restriction might result in dehydration, which can worsen kidney impairment and result in other health issues. Option (b) is likewise inappropriate because persons with chronic kidney illness shouldn’t be advised to significantly reduce their fluid intake due to potential risks. Option (d) might be suitable for some individuals with normal urine output, but James exhibits symptoms like readily bleeding and nausea, which might point to excessive fluid retention. James must therefore regularly manage his fluid intake and urine output while adhering to advice from his medical staff.
Final answer
c. James should drink an amount equal to his urine output plus 500-1000 mL per day.
Option C is correct answer. Case Study Patient With Chronic Kidney Disease