一位慢性腎臟病（CKD）病人，血清肌酸酐為 4.5 mg/dL。護理師應指導哪種飲食調整？
A client with chronic kidney disease (CKD) has a serum creatinine of 4.5 mg/dL. Which dietary modification should the nurse instruct?
- ALimit fluid intake to 500 mL daily每日將攝水量限制在500 mL
- BRestrict phosphorus intake✓ 正解限制磷攝取
- CIncrease protein intake to 1.5 g/kg/day增加蛋白質攝取至1.5 g/kg/天
- DIncrease intake of dark green leafy vegetables增加深色葉菜類蔬菜攝取
CKD 病人腎臟無法有效排泄磷，導致高磷血症及續發性副甲狀腺機能亢進，故需限制磷攝取。蛋白質攝取需適量限制（非增加）以減少尿毒素產生。深綠色蔬菜多含高鉀，需視血鉀值調整。限水需根據尿量與浮腫程度，並非一律 500 mL。
Clients with CKD cannot effectively excrete phosphorus, leading to hyperphosphatemia and secondary hyperparathyroidism, so phosphorus intake must be restricted. Protein intake should be modestly restricted (not increased) to reduce uremic toxin production. Dark green leafy vegetables are typically high in potassium and must be adjusted according to serum potassium levels. Fluid restriction is individualized to urine output and degree of edema rather than uniformly set at 500 mL.
台灣腎病衛教常由專屬衛教師負責，美國多由營養師與護理師共同評估，兩地對飲食限制的指導原則一致。