Case study describing the use of Renastep as on oral nutritional supplement as part of the dietary management of a patient with Acute Kidney Injury (AKI).
Acute Kidney Injury (AKI) with hypercalcaemia. Background of Trisomy 21 and oral aversion.
Patient was admitted following routine blood tests having been found to be in AKI. At the time of admission it was unknown if there was a background of Chronic Kidney Disease (CKD) or evolving AKI with unknown cause. The patient was given IV fluids, with serum and urinary investigations.
Only managing porridge with milk and the occasional yogurt at school. Fluid intake is poor.
Meet energy and protein requirements whilst managing potassium and phosphate intake by reducing the patients intake of cow’s milk and using Renastep and a juice based oral nutritional supplement (ONS) instead.
EAR based on weight on admission = 1201kcal/day
EAR based on ideal body weight of 55.3kg = 2430 kcals/day
12-20 mmol Ca/day
The patient was regularly reviewed in clinic; she was keen to take more porridge at home and had started taking yogurts at school. Her kidney function was improving; her serum potassium and phosphate levels had normalised. Her family were making 5 bowls of porridge per day for her; 3 bowls made with 125mls of Renastep per bowl, 1 with juice-based ONS, and 1 with cow’s milk.
Estimated Dietary Intake: 1398kcal, 38g protein, potassium 117mmol, phosphate 11.3mmol, calcium 19.5mmol.
It was felt that the patient could eat more so the family were advised to make any additional bowls of porridge with a non-calcium-fortified plant-based milk alternative.
Six months after admission:
Estimated Dietary Intake: 1590kcal, 51g protein, 25.4mmol potassium, 22mmol phosphate, 22mmol calcium