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Kidney Care Center

Recipe Oven Roasted Turkey

Recipe

Oven Roasted Turkey

Recipe by: Sonal Patel, RDN

Serving Size

8 (3 ounces)

chaf

Skill Level

Moderate-Hard

Diet Type

Dialysis

Ingredients

  • 12 lb turkey
  • 1 tsp poultry seasoning
  • 1/2 tbsp smoked paprika
  • 4 sprigs fresh parsley
  • 4 sprigs fresh rosemary
  • 1 tsp dried sage
  • 1 tsp dried thyme
  • 1/2 tsp black pepper
  • 1/2 cup olive oil
  • 1 cup low-sodium
  • vegetable stock

Directions

  1. Preheat oven to 425°F. Remove neck and giblet bag. Rinse turkey with cold water and pat dry with paper towels.
  2. Mix poultry seasonings, smoked paprika, sage, thyme, and black pepper. Rub onto turkey.
  3. Place parsley and rosemary sprigs between turkey skin and flesh.
  4. Place meat thermometer in the turkey thigh (avoiding the bone).
  5. Coat turkey with olive oil. Place turkey breast side up in a roasting pan. Cover loosely with aluminum foil.
  6. Cook for 30 minutes then reduce heat to 325°F.
  7. Begin basting the turkey every 15-20 minutes with the giblet stock and for 3-4 hours until meat thermometer registers 165°F.
  8. Let turkey rest for 30 minutes before carving.

Recipe by: Sonal Patel, RDN

Nutrients per serving

Serving Size 8 (3 ounces)

Amount per serving

Calories280
Sodium125 mg
Potassium188 mg
Phosphorus250 mg
Carbohydrates0 g
Protein32 g

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Physical Activity Reduces Heart-Related Deaths in Hemodialysis Patients

Physical Activity Reduces Heart-Related Deaths in Hemodialysis Patients

October 13, 2021

Regular physical activity is not only associated with longer life expectancy in patients on hemodialysis but also reduces heart-related deaths. These results came from a new study done on 6147 European and Argentinian patients receiving hemodialysis. Physical activity was defined as participating in lifestyle activities such as work, household chores, travel, or leisure. Heart-related deaths included sudden death, heart attack, atherosclerotic heart disease, cardiac arrhythmia, cardiac arrest, valvular heart disease, pulmonary edema, and congestive heart failure.

Occasional physical activity was associated with a 20% lower risk for overall deaths and an 18% lower risk for heart-related deaths. Frequent physical activity was associated with an 18% lower risk for overall deaths and a 23% lower risk for heart-related deaths. As physical activity increased, the risk for heart-related deaths significantly decreased. Investigators adjusted results for patients’ diets. These results suggest that even low levels of physical activities that are likely to be safe yield a significant improvement in lowering the risk for death in these patients,” Dr. Bernier-Jean’s team concluded. This study also encourages future randomized controlled trials of low-intensity physical activity for sedentary adults receiving hemodialysis.

Source: Bernier-Jean A, Wong G, Saglimbene V, et al. Self-reported physical activity and survival in adults treated with hemodialysis: a DIET-HD cohort study. Kidney Int Rep. doi:10.1016/j.ekir.2021.09.002

Author
Dr. Umair Haider

Expanded dialysis can improve quality of life in chronic kidney disease patients

Expanded dialysis can improve quality of life in chronic kidney disease patients

September 11, 2021

A hospital research team from Lawson Health Research Institute has found that expanded dialysis can improve the quality of life in chronic kidney disease patients who struggle with the side effects of traditional dialysis. Expanded dialysis is a new method that removes a broader range of toxins from the body than traditional dialysis. This study was conducted for three months with 28 patients.

The new dialyzer that was used in the study has precisely made pores that allow larger-sized toxic chemicals to be filtered from the blood while retaining essential molecules such as albumin. The chemicals that can now be filtered out can cause inflammation, malnutrition, and chronic symptoms like fatigue. Traditional dialysis treatments haven’t been as successful at removing those chemicals and some patients experienced significant side effects.

One of the study participants with chronic kidney disease had been on dialysis for about five years. He was complaining of reduced appetite, weakness, and reduced quality of sleep. He reported feeling better, improved appetite eating, and improved quality of sleep with expanded dialysis.

With the first phase of this study has been completed and published in Kidney Medicine, the next phase will include 60 dialysis patients for up to six months of treatments using the new dialyzer. This second phase will be a multicentered clinical study led by Lawson, University of Toronto, and Humber College.

SourceLawson Health Research Institute

Author
Dr. Umair Haider

FDA gives thumbs down to Tenapanor for control of Phosphorus in kidney patients on dialysis

FDA gives thumbs down to Tenapanor for control of Phosphorus in kidney patients on dialysis

September 09, 2021

FDA gives thumbs down to Tenapanor for control of Phosphorus in kidney patients on dialysis

The US Food and Drug Administration (FDA) has asked for an additional clinical trial to demonstrate the benefits of Tenapanor before it can approve the drug. Tenapanor has shown good prospects in trials for the control of serum phosphorus in adults with chronic kidney disease (CKD) on dialysis. Tenapanor is an oral drug that inhibits the sodium-proton exchanger NHE3. The drug was submitted for approval to treat hyperphosphatemia in patients with CKD on dialysis. The data is supported by three phase-3 clinical trials involving more than 1000 patients.

The FDA stated that approval of the application would require the drug manufacturer to conduct an additional “adequate and well-controlled trial demonstrating a clinically relevant treatment effect on serum phosphorus or an effect on the clinical outcome thought to be caused by hyperphosphatemia in CKD patients on dialysis.”

Patients receiving dialysis for the management of CKD are highly likely to be hyperphosphatemic. Current Therapies for Hyperphosphatemia are only moderately effective and difficult to implement. Current strategies for the management of hyperphosphatemia include more frequent hemodialysis, dietary phosphate restriction, and phosphate binder therapy. Untreated, hyperphosphatemia can lead to dystrophic calcification, accelerated arteriosclerotic vascular disease, and fractures.

In a study, 236 patients who were on dialysis and had hyperphosphatemia despite treatment with phosphate binder therapy were given 4 weeks of treatment with either the twice-daily oral Tenapanor or placebo. The results showed that the Tenapanor treatment group had a significantly greater change in serum phosphorus concentration versus placebo.

Tenapanor has previously received FDA approval in 2019 for the treatment of irritable bowel syndrome (IBS) with constipation in adults.

Source: DA Rejects Tenapanor for Control of Phosphorus in Kidney Disease – Medscape – Aug 05, 2021.

Author
Dr. Umair Haider

Peritoneal dialysis and its complications

Peritoneal dialysis and its complications

November 22, 2021

The number of patients suffering from chronic kidney disease or loss of kidney function is increasing worldwide and with it the number of people who need renal replacement therapy. One of the major tasks of the kidneys is the filtering of the metabolite from the blood. If the kidneys are no longer able to perform this task, the blood has to be cleansed and drained artificially by way of dialysis (blood washing). Some patients choose the flexible method of dialysis called peritoneal dialysis (PD), which uses the membrane of the peritoneum as a filter. The advantage of peritoneal dialysis is that it can be performed independently at home, which improves the quality of life. In addition, this vascular-sparing form of removing excess water and dissolved urinary substances can often better preserve any remaining kidney function. The solution used during PD is a mixture of dextrose (sugar), salt, and other minerals dissolved in water, called dialysis solution, which is placed in a person’s abdominal cavity through a catheter. 

Peritoneal Dialysis related infections, including peritonitis, exit‐site infections (ESI), and tunnel infections, are important complications, resulting in significant morbidity and risk of death. 

Early complications related to peritoneal access are divided into mechanical (bleeding, visceral perforation, dialysate leaks, catheter dysfunction, hernia formation, cuff extrusion) and infectious (early peritonitis, surgical wound, tunnel and exit site infections).

The most frequent and important complication of peritoneal dialysis (PD) catheters is an infection called:

  • Peritonitis, an infection of the lining of the abdominal cavity (peritoneum). This infection can also develop at the site where the tube (catheter) is inserted to carry the cleansing fluid into and out of your abdomen.
  • Weight gain. The dialysate contains sugar (dextrose). Absorbing some of the dialysates might cause you to take in hundreds of extra calories daily, leading to weight gain. The extra calories can also cause high blood sugar, especially if you have diabetes.
  • Holding fluid in your abdomen for long periods may strain your muscles.
  • Inadequate dialysis. Peritoneal dialysis can become ineffective after several years. You might need to switch to hemodialysis.

To prevent complications of peritoneal dialysis there are protocols in place to decrease the infection risk in PD patients. These include proper catheter placement, exit-site care including Staphylococcus aureus prophylaxis, careful training of patients with periodic re-training, prevention of contamination, and prevention of procedure-related and fungal peritonitis.

Author
Suzanne Naeem

Review
Dr. Umair Haider