Which foods should the practical nurse instruct a client diagnosed with end-stage renal disease to avoid?

• A. Bananas
• B. Dark-colored colas
• C. Red meats
• D. All of the above

Answer: (D)

In end-stage renal disease, the kidneys can’t effectively excrete potassium or phosphorus, so the diet must limit foods high in these minerals to prevent dangerous imbalances. Bananas are rich in potassium, and hyperkalemia can lead to life-threatening arrhythmias, so they’re commonly restricted. Dark-colored colas contain phosphate additives, which raise phosphorus levels and contribute to bone disorders and vascular problems in kidney disease, making them something to avoid. Red meats are high in phosphorus and can also contribute substantial protein and phosphorus load; since phosphorus needs to be carefully managed in ESRD, red meats are typically limited or avoided. Because all three foods raise burdens the diseased kidneys struggle to handle, they are avoided or heavily restricted in an ESRD diet.