As a frequently-occurring disease in nephrology, chronic kidney disease is a chronic kidney damage caused by many factors. In addition to taking drugs, patients should also pay attention to dietary conditioning. On the one hand, scientific nutritional therapy can improve the symptoms of kidney disease, and on the other hand, it can delay the progress of kidney disease.
Food usually consists of the following components: fat, protein, carbohydrates, water and inorganic salts. Therefore, when helping patients with chronic kidney disease to formulate a diet plan, they should not only combine the main components of food, but also refer to the specific conditions of patients with chronic kidney disease.
fat, protein, sugar
The status of renal function is directly related to the ability of the human body to excrete protein breakdown products, so the amount of protein ingested should be determined by the status of renal function.
People with normal renal function and chronic kidney disease patients with normal renal function do not need to control the normal intake of protein, of course, it should not be too much.
If renal function deteriorates, the protein intake should be reduced, especially when the renal function is moderately impaired, the protein intake should be limited to 0.6-0.8 grams of protein per kilogram of body weight per day. Mainly select high-quality protein, reduce the intake of vegetable protein, increase the proportion of animal protein to more than 60%, and eat more eggs, milk, lean meat, etc.
Dialysis patients Due to protein loss, dialysis patients should gradually increase their protein intake. The recommended protein intake is 1.2 grams per kilogram of body weight per day; if the patient is in a high catabolic state, the protein intake should be increased to 1.3 grams per kilogram of body weight per day; when the peritoneal dialysis patient is in a stable state, the protein intake should reach 1.3 grams per kilogram of body weight. 1.2 to 1.3 grams per kilogram of body weight per day.
Patients with chronic kidney disease should reduce the intake of trans fatty acids and animal fats, and eat less saturated fatty acids, such as animal fats such as lard. Patients with hyperlipidemia should take it with caution. In addition, trans fatty acids are not good for cardiovascular, so fried foods and pastries should be eaten less.
Insufficient protein and energy intake can easily lead to malnutrition in patients with chronic kidney disease, which is a risk factor for increased mortality from the disease. The use of alpha keto acids can be increased in combination with a low-protein diet.
water and inorganic salts
When the phosphorus kidney is damaged, the excretion of phosphorus decreases, resulting in an increase in blood phosphorus; due to the decrease in the synthesis of vitamin D 3 , a lot of calcium is excreted through urine protein. The content decreases, causing osteoporosis. Therefore, it is necessary to increase the intake of calcium and control the intake of phosphorus. Adults can consume 1000-1500 mg of phosphorus per day in normal diet, and the intake of phosphorus in patients with high phosphorus with kidney disease should be limited to no more than 800 mg per day (preferably about 500 mg per day). Foods with high protein content generally contain more phosphorus, so a low-protein diet reduces the intake of phosphorus. The amount of calcium supplementation should be 1000-1500 mg per day. However, when blood phosphorus is too high, it is necessary to take a large amount of calcium with caution.
Potassium Potassium intake does not need to be managed if the patient has a daily urine output of more than 1000 mL and normal serum potassium. If the patient has decreased urine output (less than 1000 mL per day), has a tendency to hyperkalemia (ie, serum potassium greater than 5.5 mmol/L), renal insufficiency, and the use of angiotensin-converting enzyme inhibitors (with the word “Puri”) And angiotensin receptor antagonists (with the word “Sartan”), it is necessary to prevent the consumption of potassium-rich foods, not more than 1500 to 2000 mg per day. Fruits and vegetables such as melons and fruits (including winter melon, gourd, pear, apple, pumpkin, pineapple, grape, watermelon, etc.) are not high in potassium and can be eaten. And kelp, spinach, rapeseed, tomatoes, leeks, kiwi, peaches, oranges, bananas and other fruits and vegetables, as well as mushrooms, seaweed, lilies, dried dates and other goods and mushrooms, beans, etc., are all high potassium foods. Of course, high-potassium foods can also be eaten, but only selectively under the premise of limiting the total amount. For example, when blood potassium drops or urine volume increases, potassium supplementation should be given under the guidance of a doctor.
Water and sodium The sodium intake from food should be changed at any time according to the change of the condition, and it should be controlled at about 5 grams per day as much as possible. When the patient has obvious edema or complicated hypertension, the intake of sodium salt (2-3 grams per day) and water (less than 1000 ml per day) should be controlled. If the patient’s daily urine output is less than 500 ml, sodium intake should be resolutely controlled. When the patient’s edema is not obvious or dehydration occurs, the daily intake of fluid is to increase the urine output of the previous day by 500 ml; if the patient is complicated by symptoms such as vomiting, fever, and diarrhea, fluid supplementation should be added.
Most people with chronic kidney disease tend to have some complications. Compared with hyperuricemia, purine intake should be controlled, and patients with diabetes should pay attention to changes in blood sugar.
Metabolic disorders and malnutrition are common in patients with chronic kidney disease before dialysis or dialysis. Intensive nutritional support is a key part of improving the quality of life and prognosis of these patients. All patients should formulate a personalized diet plan based on renal function status (such as renal function staging) and various complications.