Volume 13, Issue 2 February Inside this Issue

Transcription

1 Volume 13, Issue 2 February 2018 Heart disease is very common in people with kidney disease or kidney failure. In efforts to protect your heart, there are things you can do to keep your heart and blood vessels healthy and/or prevent heart disease from getting worse. What is heart disease? Heart disease describes a number of disorders that can affect the heart or blood vessels. Doctors call these disorders cardiovascular disease. (Cardio means heart and vascular means blood vessels. ) Your heart and blood vessels work together to bring oxygen to all parts of your body, including your brain, kidneys, legs, and lungs. Having damage to either your heart or your blood vessels can be very serious. It can lead to chest pain, heart attack, stroke, or even death. Two common types of heart disease are: Heart failure: Heart failure does not mean your heart has stopped pumping. It means your heart cannot pump well enough to move blood and fluids through your body (including to your kidneys). Heart failure happens slowly over time as the pumping action of the heart grows weaker. Coronary Heart Disease: This disease happens if the blood vessels that bring oxygen to the heart become stiff, narrow, or blocked. Even if the heart pumps well enough, the blood cannot move well through the blood vessels. Why am I more likely to get heart disease if I am on dialysis? Kidneys play a major role in regulating blood pressure. At any given moment, healthy kidneys ensure that blood levels of water, salts, and other key chemicals (such as potassium, calcium, and phosphorus) are in perfect balance. (Continued on page 6) Inside this Issue Dialysis and Heart Health 1 Product Pages: 2-3 Recipe of the Month: Social Worker s Dialysis and Hearth Health (continued) Emergency Diet in review 1 Day Emergency CKD Diet Exam Birthdays 8 Winter Word Search 8

2 Mercy Dialysis Product Pages nutrition news you can use! DIETITIAN RESEARCHED Better Choice: Supplements Purchase online at: *Talk to your pharmacy, often they may order it for you to pick up. Nepro with Carb Steady (8 ounces) Nepro Butter pecan, vanilla or berry Calories g 37.9 g 250 mg 250 mg 250 mg 170 mg Purchase LiquaCel online at: *Talk to your pharmacy, often they may order it for you to pick up. Purchase Unjury online at: *Talk to your pharmacy, often they may order it for you to pick up. Unjury (1 scoop, ~27g) Unjury All powder varieties Calories g 3 g 90 mg 135 mg 130 mg 70 mg LiquaCel (1oz.) LiquaCel Peach Mango, Orange, Grape, Watermelon, Lemonade Calories g 9 mg 30 mg 10 mg 6 mg 2 mg Pure : Natural Whey Powder has no added phosphorus* Purchase online at: Available at: Walmart Pure Natural Whey Powder (1 scoop, 66 g) French Vanilla or Pure Rich Chocolate Calories g 6 g 55 mg 105 mg 107 mg 79 mg P a g e 2 Note: *Product ingredients are always changing. Please, continue to read ingredient labels.

3 Mercy Dialysis Product Pages nutrition news you can use! DIETITIAN RESEARCHED Avoid: Supplements Ensure Enlive Calories 350 Milk/Dark Chocolate, Vanilla, Butter pecan, 20.0 g 45 g 240 mg 590 mg 500 mg 350 mg Boost Chocolate, Vanilla, Strawberry Calories g 41 g 150 mg mg 300 mg 300mg Ensure Plus Calories 350 Milk/Dark Chocolate, Vanilla, Butter pecan, Strawberry, 13.0 g 51 g 220 mg 570 mg 300 mg 300 mg Atkins Calories 160 Quick tips when selecting a protein supplement Chocolate Delight 15.0 g 5 g 250 mg 560 mg 400 mg 500 mg Look on the nutrition label for: >10 g protein/serving mg phosphorus/g protein/serving Determine how much phosphorus is in something using %DV: 1000mg is the DV; 10% DV= 100mg phosphorus *Something with 20g protein should have less than 240mg phosphorus <140 mg sodium/serving <200 mg potassium per 1/2 cup serving Look for supplements where the grams of sugar are less than or equal to the grams of protein Look for less fluid with more protein Note: *Product ingredients are always changing. Please, continue to read ingredient labels. P a g e 3

4 February Recipe Strawberry Fresh Lemonade Ice Cream Ingredients 1 10oz package frozen sweetened strawberries 1 tablespoon lemon juice 1 cup crushed ice 1 cup almond milk (Silk) 1/2 cup sugar Few drops red food coloring *try adding vanilla for additional flavor Directions Thaw strawberries just until they break into chunks. Place all ingredients in a blender. Blend until smooth and sugar is dissolved. Pour into covered dish. Freeze until firm. Step it up: put ice cream between 2 Graham crackers, wrap in plastic wrap and freeze for an ice cream sandwich. Makes 8, 1/2 cup servings Nutrients for 1/2 cup serving: Calories 76.3kcal Fat 0.3g Cholesterol 0mg s 4.8g <1g 15.6mg Fiber <1g 89.1mg 10.9mg 61.3mg P a g e 4

5 Social Worker s Corner P a g e 5

6 (Continued from page 1) When kidneys begin to fail, this very precise system starts to fall apart. Often dialysis patients experience high blood pressure due to the damaged kidneys not filtering out excess minerals, and fluids. The body retains extra fluid in the blood in efforts to balance the build up of minerals due to the kidneys not filtering them out. The extra fluid causes high blood pressure which can damage and scar blood vessels thruoghout the body including in your kidneys. Scar tissue build up makes it even harder for blood to flow through the body as the heart pumps, making the heart work harder. As your heart works harder to pump blood through the body, it begins to thicken and grow larger (like any muscle that gets a lot of exercise or work). Ultimately, your heart begins to get tired and loses its ability to pump blood well enough. When this happens, your heart can not pump blood to all parts of your body (also known as Heart Failure). What else affects my risk for heart disease? Weight: overweight Smoking Age: men older than 45 women over 55 Family history of heart disease Diabetes Not getting regular exercise High levels of fats like cholesterol in the blood High blood pressure Are there tests to check for heart disease? Yes, some tests for heart disease may include: An electrocardiogram (ECG) A graph record of the heart s electrical activity that tells your healthcare provider if your heart rate and heart beats are normal or if heart damage has occurred. An ECG should be repeated once a year or as instructed by your doctor. An echocardiogram Sends sound waves into the chest to show the shape and movement of the heart valves as well as the size of the heart chambers and how well they are working. A stress echocardiography To help check for blockage in the arteries leading to the heart. This test involves taking an echocardiogram before and during or right after physical stress, usually exercise on a treadmill. Sometimes a type of test called nuclear imaging may be used instead. An angiogram (x-ray of the arteries or heart) To pinpoint an area of blockage and help decide on the best treatment for you. A small tube called a catheter is inserted into a blood vessel in your groin or arm. The tip of the tube is positioned either in the heart or at the beginning of the arteries supplying the heart. A special fluid called contrast dye is injected. The dye is visible by x-ray, and the pictures obtained are called angiograms. Your healthcare provider may decide to use a special type of contrast dye that is safe for most people on dialysis. *Be sure to talk to your doctor about your risk for heart disease. P a g e 6

7 Hemodialysis Patients What should I know about emergency meal planning? 1. Be careful when eating foods that may spoil to avoid food poisoning. If a jar or can is opened, do not keep it longer than four hours unless refrigerated. A full refrigerator will hold the temperature for about 48hrs (24 if it is half full). 2. Use disposable plates and utensils. Throw away after use. 3. Keep distilled water (available at your local supermarket) handy for mixing milk or juice. Mix small amounts of only four ounces at a time. 4. Limit intake of fluid to two cups or 16 ounces per day. Chew gum to help cope with thirst and dry mouth. 5. Do not use salt or salt substitutes with your meals. Use salt-free foods, whenever possible. 6. Avoid high-potassium foods including high potassium fruit juices (orange juice). *If you have diabetes, keep instant glucose tablets, sugar, hard candy, low-potassium fruit juices, or sugared soda pop on hand to treat low blood sugars. Peritoneal Dialysis Patients Will I need to change my diet if I am able to do peritoneal dialysis (PD)? If you are able to keep your current level of dialysis using your machine or manual exchanges: 1. Keep protein intake to 6 ounces or more each day. 2. You need not change the amount of potassium intake each day. 3. Continue to limit calcium and high-phosphorus products and keep the phosphate-binder regimen. If you cannot perform as many exchanges as usual, then follow the basic guidelines, including limiting fluid and potassium sources. Additional info at:national Kidney Foundation Website *Ask your dietitian if you have any questions or concerns regarding your emergency diet. 1 Day Emergency Chronic Kidney Disease Diet Example Breakfast ½ cup milk prepared from dry milk and ½ cup distilled water or ¼ cup evaporated milk with ¼ cup distilled water 1 single serving of cereal (½ ¾ cup) 1 tablespoon sugar ½ cup pineapple (single serving) Morning snack 5 vanilla wafers Honey or jelly as desired on wafers 10 sourballs Lunch 2 slices white bread ¼ cup low-sodium tuna (open new can daily) 1 tablespoon margarine or mayonnaise (single packet or open new jar daily) ½ cup pears (single serving) Powdered drink mix with ½ cup distilled water Afternoon snack 6 unsalted crackers Honey or jelly as desired on crackers 10 jelly beans Dinner 2 slices white bread ½ cup (2 oz.) low-sodium chicken (open new can daily) 2 tablespoons margarine or mayonnaise (single packet or open new jar daily) ½ cup peaches (single serving) ½ cup cranberry juice (from box or pouch) Evening snack 3 graham crackers Honey or jelly as desired on crackers 10 mints P a g e 6 P a g e 7 P a g e 7

8 Ten Heart Tips for a healthier heart Follow a heart-healthy diet Get regular physical activity Control your blood pressure Control your cholesterol levels Keep calcium and phosphorus in balance Control your blood sugar if you have Diabetes Treat anemia Stop smoking Reduce stress Maintain a healthy weight 2nd Shannon J. 2nd Raymond H. 7th Clara S. 8th Paul M. 19th Andre B. 19th Catherine F. 25th Robert H. 26th Mukesh P. 27th Gus F. 28th John C. Mercy Health Plaza 5264 Council St. NE Cedar Rapids, IA Mercy Medical Center th St. SE Cedar Rapids, IA Mercy Dialysis Vinton 502 N. 9 th Ave Vinton, IA Page 8