The Japanese Journal of Clinical Dialysis Vol.32 No.12(2-7)

Theme Nutritional care for elderly chronic kidney disease patients utilizing rehabilitation and kinestology
Title A case of elderly chronic kidney disease patient with visual disturbances from diabetic retinopathy
Publish Date 2016/11
Author Kanae Asai Department of Metabolism and Clinical Nutrition, Kyoto University Hospital
Author Ayako Miseki Department of Metabolism and Clinical Nutrition, Kyoto University Hospital
Author Kenichiro Shide Department of Metabolism and Clinical Nutrition, Kyoto University Hospital
[ Summary ] A 70-year-old woman with chronic kidney disease (stage G4A3), type-2 diabetes, and hypertension was admitted to hospital for treatment of her deteriorating glycemic condition and renal function. We found that her visual disturbances from diabetic retinopathy and finger deformity from rheumatic arthritis had hampered medication adherence. Additionally, the patient rarely cooked and her diet was mainly comprised of meals with excessive sodium intake. These types of patients have low physical activity levels, suggesting sarcopenia and frailty. Our medical team carried out comprehensive medical interventions and health guidance tailored to her health conditions and life style. An enlarged copy of booklet with illustrations was used to facilitate her understanding in nutritional counseling. Low salt meals were proposed to lighten her cook load. Light aerobic and resistance exercises at sitting position was introduced as safe and feasible kinesitherapy. Since the patient is highly likely to need blood purifying treatments in the near future, correction of her poor nutrition by successive nutritional management and exercise therapy is critical for better prognoses.
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