Hello, I'm a nutritionist with a big face.

Presumably, everyone knows the importance of the kidney. The kidney is the metabolic organ of the human body, which can excrete human metabolic wastes (such as urea, creatinine and uric acid) through urine to maintain human life and health.

However, due to various reasons (such as diabetic nephropathy, immune nephropathy, etc.), the kidneys began to have problems and their working ability decreased, so that many toxins could not be excreted from the body.

We call this condition chronic kidney disease (CKD), that is, chronic renal insufficiency. CKD is divided into 1-5 stages according to the severity of the disease, and the final stage is the fifth stage (also known as uremia stage). With the progress of the disease, dialysis treatment or kidney transplantation can only be used in the end stage of renal disease.

A reasonable and effective diet will help patients with chronic kidney disease to control their condition, and even the disease can be effectively improved.

with chronic kidney disease, what should I pay attention to in my diet?

Nutrition principle:

1. Restrict protein's intake

In patients with kidney disease, the protein intake cannot be well utilized by the body and will be excreted from the urine, and the process of eliminating proteinuria every time is actually a kind of harm to the body.

Therefore, we must control the intake of protein in one day, so as to meet the needs of the body's metabolism without excessive intake. Protein is advised to take .8g-1.g/ day /kg for CKD D1-2, and protein is advised to take .6-.8g/ day /kg for patients with CKD3-5. The weight here refers to the ideal weight.

For example, if a female patient with CKD stage 3-5 is 165cm in height and her ideal weight (simplified formula) is 165-15=6kg, then her whole-day protein intake should be controlled at 6x.6 or .8 = 36-48g/day.

Therefore, when we choose protein, we should choose high-quality foods from protein. The so-called high-quality protein refers to protein whose amino acids are similar to those of protein.

This protein has high nutritional value and is easy to be utilized by the body, thus reducing the metabolic burden of the kidney. For example: eggs, meat, fish, milk, soybeans and their products.

Of course, we can't just eat these foods in one meal, and there will also be staple food, vegetables and fruits, but the protein of these foods is actually not high-quality protein.

Because there is a limit on the intake of protein in one day, I must choose some low-protein foods, or I will consume too much protein.

For example, you can choose the staple food: noodles, vermicelli, water chestnut cake, crystal dumplings, crystal cakes, silver needle powder, lotus root starch, etc. The protein price of these staple foods is lower.

Or you can choose potato, red (white) potato, lotus root, yam, taro and other foods which are also rich in starch to replace the staple food.

Of course, we can even buy some low-protein rice specially for patients with kidney disease, which is also recommended.

how do you know how much protein is in food?

We can look at the food ingredients list: For example, this kind of vermicelli has almost no protein, while rice has protein, which is why vermicelli should be used instead of rice.

when we adopt a low-protein diet, we should supplement the compound ι-keto acid tablets when necessary, and remember to ask the doctor in the department of nephrology to prescribe it, so that the collocation effect is good.

2. Limit the intake of foods with high phosphorus and potassium

Due to poor renal function, phosphorus and potassium in the body cannot be effectively excreted through urine, and it is easy to accumulate in the body. Too much accumulation will lead to poisoning.

When blood phosphorus is high, animal liver, nuts, dried beans and various processed foods containing phosphorus should be carefully selected. When blood potassium is high, oranges, oranges and other fruits, potatoes and their starch should be carefully selected.

table of potassium and phosphorus content in common foods (mg/1g)

Because there are too many kinds of foods, we can't list them one by one. I suggest you download the "Mint Health" APP, and after you enter the food you want to know, it will contain the potassium and phosphorus content of the food.

in my personal opinion, if the value exceeds 5, I suggest that it is best not to eat it, or strictly control the intake. For example, dried laver (1796mg/1g) in the above table is highly recommended.

3. Low-salt diet

It is best to control the salt in patients with nephropathy at 6g/d. If there are obvious proteinuria, edema, hypertension and oliguria, it can be controlled at a lower level (3g/d). Eating too salty is easy to cause edema.

It is recommended to eat less or no pickled food such as pickles and sausages. Of course, soy sauce and monosodium glutamate also contain salt, which should be restricted.

4. Limit the amount of drinking water

Renal dysfunction in patients with kidney disease will lead to decreased urine volume, and oliguria or even anuria will begin to appear. Because urine cannot be excreted from the body, it will leave the body in a state of edema.

therefore, we must control the intake of liquid. The liquid intake includes porridge, water, milk, soup, traditional Chinese medicine, etc. It is suggested that the liquid intake of the day is 5 ml+the urine volume of the previous day.

Tip: Ways to relieve thirst:

(1) Drink water in a planned way and fill it with graduated cups or containers.

(2) The diet is light. When you have dry mouth, you can use ebony and olive to relieve the symptoms of dry mouth, or you can spit it out after rinsing your mouth with clear water.

Other precautions:

1. Patients with kidney disease are often accompanied by hyperuricemia, so it is not recommended to drink old fire soup, cooking gravy, chicken soup, bone soup, fish soup, etc.

2. It is suggested that all ingredients should be blanched before cooking, and then thrown away. This method can reduce the intake of potassium, phosphorus, sodium and purine.

3. fruits: fast carambola and avoid eating some hot and humid fruits, such as mango, pineapple, litchi and longan.

4. Patients with chronic kidney disease need to take calcium supplements and consult a doctor.

5. Because everyone's height, weight, sex, age, activity, diet history, illness and stress are different, I can't tell you directly how much to eat. Can only tell a general principle of adaptation. Specifically, I suggest that you go to the hospital to consult a professional dietitian.

6. The dietary requirements of patients with chronic kidney disease are strict. It is beneficial to improve the nutritional status of patients and delay the development of kidney disease to follow the doctor's advice and strictly implement it.

7. Once the disease progresses to the point where dialysis treatment is needed, the principles of nutrition treatment will change, and the above dietary principles are no longer applicable.

if you think it is useful, remember to give me a compliment and share it with those around you who need it! There is still something you don't understand about the diet of chronic kidney disease (CKD). You can leave a message for consultation.

References:

1. How to create a kidney diet to reverse chronological kidney disease.co-authored by Marsha Durkin, rn. last updated: January 9, 22. Wikihow.

2. Clinical Practice Guidelines for Nutritional Treatment of Chronic Kidney Disease in China (221 Edition)

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