PATIENT EDUCATION

How to Get the Most From Your Iron Supplement Nancy Da$e, RD, CSR, * and Aura Kiefev, RDf

“How to Get the Most From Your Iron Supplement” was developed to address four educational needs:

1. Educate renal patients about the important functions of iron. 2. Help the patient identify “Excellent” common food sources of iron and to find foods

“Enriched” with iron by reading FDA’s Percent Daily Value on the Nutrition Facts Food Label.

3. Focus on iron absorption enhancers vs iron absorption blockers. 4. Eliminate confusion regarding timing of their medications. The pictorial “Quiz”

visually reinforces the correct time to take the iron supplement versus the phosphorus binder.

Use part or all of this education tool; highlighting, for the patient, the information that is most pertinent to his/her situation.

Bibliography

Mahan L, Stump S (eds): Food, Nutrition and Diet Therapy. Philadelphia, PA, Saunders, 1996, pp 140-141, 721-723

National Livestock and Meat Board: Iron in Human Nutrition. 444 N Michigan Ax, Chicago, IL 60611, National Livestock and Meat Board, 1995

Spratte G, Woods AL (eds): RN Magazine’s NDR 94-Nurse’s Drug Reference. Albany, NY, D&m, 1994, pp 25-29

Developed by *Nancy Da&&, RD, CSR, Renal Dietitian, San Diego Dialysis, Chula Vixfa South Dialysis Unit, 2252 Verus St, San Diego, CA 92154, and fAum Ki@, RD, Rennl Dietitian, San Diego Dialysis, Natioml City Dialysis UGt, 303 W26th St, Aktionni City, CA 91950.

Thir Patient Irlfbrwlation Form rnq bephotocopiedfor the pqmse of distribution to patients only, but notfor any otherpuuposes, such as copyirzgjw

general distribl4tion, for advertising orpromotioizalptlvposes, for creating new collective works, orfor resale. Professional review and adaptation beforepatient use is encouraged. 0 1999 by the National Ki&ey Foutzdation, Inc.

1051.2276/99/0901-0010$3.00/0

46 J~wnal ofRenal Nuftition, Vol9, No 1 (January), 1999: pp 46-48

EXC

ELLE

NT

SOU

RC

ES

OF

IRO

N

IN Y

OU

R

REN

AL

DIE

T

*FDA

de

fines

an

EX

CELL

ENT

SOUR

CE

of

IRO

N as

at

leas

t 20

%

DAIL

Y VA

LUE

&hec

k th

e La

bel:

- Iro

n 20

-

100%

EX

CELL

ENT

SOUR

CE

IRON

FO

RTIF

IED

CERE

ALS:

-G

ENER

AL

MIL

LS

MUL

TI

- GR

AIN

CHEE

RIO

S PL

US

-KEL

LOGG

’S

PROD

UCT

19

-MAL

T-O-

MEA

L (n

ot

choc

olat

e va

riety)

-T

OTAL

CO

RNFL

AKES

-Q

UAKE

R IN

STAN

T O

ATM

EAL

-SNA

CKW

ELLS

CE

REAL

BA

RS

- AN

Y FL

AVOR

-S

UN

COUN

TRY

QUIC

K OA

TS

MEA

T,

FISH

OR

PO

ULTR

Y:

-BEE

F,

LAM

B,

PORK

, VE

AL

-CLA

MS

-FIS

H:

Tuna

, lig

ht,

Fres

h or

Fr

ozen

-P

OULT

RY:

CHIC

KEN,

TU

RKEY

-C

ALVE

S LI

VER

-if

your

ph

osph

orus

is

usua

lly

norm

al

on

lab

day

*Coo

k in

IRO

N sk

illets

wh

enev

er

poss

ible

.

.Wha

t is

you

r R

enal

M

eat

Serv

ings

Al

low

ance

? A

sk

your

R

D

HOW

TO

GE

T TH

E M

OST

FRO

M

YOU

R

IRO

N

SUPP

LEM

ENT

*Vita

min

C

enha

nces

th

e ab

sorp

tion

of

your

Iro

n Su

pplem

ent.

*FDA

de

fines

an

EX

CELL

ENT

SOUR

CE

of

VITA

MIN

C

as a

t le

ast

20%

DA

ILY

VALU

E &h

eck

the

Labe

l:

- Vi

tam

in

C 20

-

100%

EX

CELL

ENT

SOUR

CE

Som

e ex

celle

nt

sour

ces

of

Vita

min

C

are:

-C

ranb

erry

Ju

ice

Cock

tail

(regu

lar

or

Redu

ced

Calo

rie)

with

in

your

flu

id

restr

iction

-B

eroc

ca,

Neph

ro-V

ites,

Ne

phro

caps

or

Vi

tam

in

c ta

blet

(1

OO-

250m

g)

.DO

TA

KE

YOUR

IR

ON

SUPP

LEM

ENT

IN-B

ETW

EEN

MEA

LS

OR A

T BE

DTIM

E W

ITH:

l/2

cu

p Vi

tam

in

C EN

RICH

ED

CRAN

BERR

Y JU

ICE

and

Rena

l Vi

tam

in

or V

itam

in

C ta

blet

. *If

ta

king

Iron

on

an

empt

y sto

mac

h bo

ther

s yo

u;

you

can

take

: wh

ite

toas

t or

wh

ite

flour

cra

cker

s wi

th

Unsa

lted

Tops

, va

nilla

wa

fers

or

Sn

ackw

ells

Cere

al

Bars

wi

th

the

Cran

berry

Ju

ice.

*DO

NO

T TA

KE

YOUR

IR

ON

SUPP

LEM

ENT:

-

AT

MEA

LS

OR

SNAC

KS

WIT

H PH

OSP

HORU

S BI

NDER

S.

Iron

supp

lem

ents

an

d Ph

osph

orus

bi

nder

s bi

nd

with

ea

ch

othe

r m

akin

g bo

th

med

icatio

ns.

inac

tive.

-O

R W

ITH:

M

ILK,

YO

GURT

, IC

E CR

EAM

, PU

DDIN

G,

COTT

AGE

CHEE

SE,

EGGS

, SE

EDS,

BR

AN,

TOFU

, SO

Y M

ILK,

NE

PRO

(o

r ot

her

Cann

ed

Supp

lem

ent),

CO

FFEE

or

TE

A (re

gular

or

de

caffe

inat

ed)

Thes

e pr

oduc

ts de

crea

se

the

abso

rptio

n of

Iro

n.

Any

prob

lem

s?

Ask

yo

ur

RD

QU

IZ

QU

ESTI

ON

: W

hat

happ

ens

if yo

u ta

ke

your

iro

n Su

pple

men

t w

ith

your

ph

osph

orus

bi

nder

?

ANSW

ER:

The

Iron

Supp

lem

ent

will

be

bo

und

by

the

phos

phor

us

bind

er

and

take

n ou

t of

yo

ur

body

in

the

st

ool.

WTh

e Iro

n ne

ver

ente

rs

into

yo

ur

bloo

dstre

am.

You

coul

d be

in

da

nger

of

de

velo

ping

an

emia

. Si

nce

the

phos

phor

us

bind

er

is a

ll “u

sed

up”

it ca

nnot

do

th

e jo

b of

bi

ndin

g th

e ph

osph

orus

in

you

r fo

od.

bThe

ph

osph

orus

en

ters

in

to

your

bl

oods

tream

. Yo

u co

uld

be

in

dang

er

of

deve

lopi

ng

rena

l bo

ne

dise

ase.

Nife

rex

150

Ferro

us S

ulfa

te

(FES

04)

Slow

-Fe

Ferro

us Fu

mar

ate

IRON

SU

PPLE

MENT

S SE

RVED

IN

-BET

WEE

N ME

ALS

l NEV

ER

SERV

ED

WITH

PH

OSPH

ORUS

BI

NDER

BOB’

S R

ESTA

UR

ANT

*DAI

LY

SPEC

IALS

. PH

OSPH

ORUS

BI

NDER

S SE

RVED

W

ITH

MEAL

S -N

EVER

SE

RVED

W

ITH

IRON

SU

PPLE

MENT

Phos

Lo

Cal

phro

n Tu

ms

Cal

cium

Car

bona

te

Osc

al

Cal

ci-C

hew

Ti

trala

c Am

phoj

el

Basa

ljel

Rem

embe

r to

ta

ke

your

ph

osph

orus

bi

nder

w

ith

you

whe

n yo

u go

ou

t to

re

stau

rant

s.

Ther

e is

pho

spho

rus

in f

ood

no

mat

ter

whe

re

you

eat

it!