A patient ready for discharge after treatment for chronic renal failure should be reinforced with which dietary instruction?

• A. Make sure to include carbohydrates in your diet
• B. Significantly restrict fluids
• C. Eat a low-protein diet
• D. Limit sodium to avoid edema

Answer: (A)

The key idea is energy needs and protein sparing in kidney disease. In chronic renal failure, the body’s protein is often restricted to limit nitrogenous waste, but if calories come up short, the body will break down its own protein to meet energy demands. Providing adequate calories from carbohydrates helps prevent this protein catabolism, preserving protein for tissue repair and maintaining nutritional status without increasing the kidney’s workload. That’s why reinforcing that carbohydrates should be included in the diet is the most appropriate discharge instruction.

Other options aren’t as universally appropriate. Fluid restriction is tailored to fluid status and may not be necessary for every patient at discharge. A low-protein diet is common during kidney disease, but once treatment is underway and nutrition is being managed, protein is still needed to prevent malnutrition. Limiting sodium helps with edema management but doesn’t address the fundamental need to supply energy to spare protein.