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Shock is likely due to valproic acid, so the shock may not resolve until after initiation of hemodialysis

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Adjusting your protein strategy may involve: Increasing protein density: Choosing higher-protein versions of foods (Greek yoghurt instead of regular, protein-enriched bread) Protein-first eating: Consuming protein sources at the beginning of meals when appetite is strongest Smaller, more frequent protein servings: Distributing intake across 4-5 eating occasions rather than 3 main meals Supplementation: Adding protein powder to beverages, porridge, or soups when whole food intake is insufficient Professional monitoring should include: Regular body composition assessments (where available) to track lean mass changes Discussion of dietary intake patterns at follow-up appointments When to seek additional support: Contact your GP or request dietitian referral if you consistently struggle to meet your protein targets, experience unexplained weakness, or have concerns about your nutritional status