Discussion Part Three (graded) A 60-year-old patient comes into your office with a history of hypertension and a myocardial infarction 13 years ago. You notice that both of her ankles are swollen and that her skin seems shiny. She first noticed her ankle swelling 9 months ago and it has gotten progressively worse. She has a smell of ammonia on her. She also has a 2 year history of diabetes. What are at least five systemic effects of chronic kidney disease? How would you modify the diet and what is the rationale to the changes of the diet that you make?
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