Things that peritoneal dialysis patients are easy to worry about

That's ... itchy.

itchy skin

Why is this so

It is likely that "hyperphosphatemia" is at work.

Phosphorus is a mineral element in human body, which participates in the composition of bones, teeth and other tissues, the synthesis of various enzymes and the maintenance of neuromuscular functions, and plays a very important role in maintaining human life activities.

The kidney is the main organ for phosphorus excretion, and about 70% of phosphorus is excreted by the kidney. When renal failure occurs, the ability of kidney to excrete phosphorus will be significantly reduced, and hyperphosphatemia is often complicated. Long-term high phosphorus stimulation can not only cause secondary hyperparathyroidism, abnormal metabolism of minerals and bones, but also lead to metastatic calcification of heart valves, blood vessels and soft tissues, which reduces the quality of life of patients and increases the risk of all-cause death and cardiovascular death. Therefore, it is of great significance to find hyperphosphatemia early and control it at the standard level.

At present, the clinical treatment of hyperphosphatemia in chronic kidney disease generally follows the "3D principle", that is, controlling hyperphosphatemia through diet restriction, dialysis dephosphorization and drugs. Among them, limiting phosphate in diet is the first step to prevent and manage hyperphosphatemia. Let's pay attention to how to control hyperphosphatemia through diet management.

(1) Boiling is healthier.

Boiling food to remove soup before eating can effectively reduce the intake of phosphorus, potassium, sodium and purine. , animal and plant ingredients are ok. The degree of phosphorus reduction is related to water consumption, food size, cooking time, peeling or not. We can cut the meat into small pieces, cook it in white water and drain the soup before eating. Boiling before eating can reduce the phosphorus content of vegetables by 565,438+0%, beans by 48% and meat by 38%. In addition, broth and bone soup contain high phosphorus, so it is recommended to drink less.

(2) Food additives are absolutely taboo.

As the main component of food additives and preservatives, phosphorus exists widely in daily life. If you see the words disodium hydrogen phosphate, calcium dihydrogen phosphate, sodium dihydrogen phosphate and trisodium phosphate in the food composition table, it means that the food contains inorganic phosphorus, and 90 100% of these phosphorus can be absorbed by the human body, so you need to read the instructions carefully when buying packaged food, and you should avoid eating processed food at ordinary times. Such as canned food, fruit juice beverage, evaporated milk, soybean milk, sausage, ham, hamburger, coffee, milk tea, carbonated beverage, beer and seasonings such as Chili powder, chicken essence, monosodium glutamate, curry powder and sesame sauce.

(3) Limit the total intake of protein.

Low-protein diet is an effective way to limit phosphorus intake in CKD patients, but low-protein diet in renal failure patients, especially peritoneal dialysis patients, may cause malnutrition. Therefore, it is necessary to seek a balance between protein and phosphorus intake. In the case of adequate intake in protein, the less phosphorus intake, the better. We should not blindly pursue a high-protein diet to maintain nutritional status or a low-protein diet to control blood phosphorus.

(4) Choose foods with low phosphorus-protein ratio.

For meat, eggs, seafood, milk and other foods rich in animal protein, special attention should be paid to the phosphorus/protein ratio as an important indicator to judge the phosphorus content of food. Hypoalbuminemia and hyperphosphatemia are common complications for peritoneal dialysis patients. Therefore, foods rich in protein and low in phosphorus content should be selected, that is, foods with low phosphorus-protein ratio (12mg/d) to ensure adequate intake of protein and avoid hyperphosphatemia. For example, egg white (phosphorus/protein ratio is only 1.4mg/g) is very suitable for patients with hyperphosphatemia; However, animal internal organs, including liver, kidney, heart, brain, intestine, fish eggs, crab roe, egg yolk, etc., have a high proportion of phosphorus protein and should be avoided as far as possible.

(5) Try to avoid foods with high phosphorus content.

For beans, vegetables, fruits and nuts, we should pay special attention to the phosphorus content and try not to eat high phosphorus content. It is suggested that every 100g food should contain 300mg of phosphorus and eat as little as possible. 100mg can be eaten more; In the middle, eat in moderation.