The diet of chronic renal failure can be summarized as “three low and two high”, three low: low protein, low phosphorus, low fat; two high: high calories, high essential amino acids
1.Low protein diet
If protein intake is too low, malnutrition is likely to occur, in terms of chronic renal failure, protein intake should be limited to 0.5~0.7g/(kg・d), see Table 1.
Endogenous creatinine clearance (ml/min)
Serum creatinine(μmol/L(mg/dl))
Blood urea nitrogen (mmol/L( mg/dl))
Protein intake
g/day
g/(kg body weight/day)
40~400
<177(2.0)
<10.7(30)
50~70
0.7~1.0
20~40
177~355(2.0~4.0)
10.7~17.9(30~50)
40~50
0.6~0.7
10~20
355~707(4.0~8.0)
17.9~35.7(50~100)
30~40
0.5~0.7
5~10
707~1060(8.0~12)
>35.7(100)
25~35
0.5~0.6
Note: If the blood creatinine reaches 800μmol/L or more, the daily protein intake should be limited to 30g, and too low protein such as 20g/d should be taken in combination with essential amino acids.
Points to note for low protein diet.
①Protein to ensure 50% to 70% quality protein, recommended: egg white, milk, fish, lean meat (common protein content (per 100g of food) is as follows: rice 7g, flour 9g, soybeans 36g, mung beans 24g, tofu 7.4g, cabbage 2g, eggplant 2.3g, apple 0.4g, peanuts 27g, pork 9.5g, beef 20g, human milk 1.5g, cow’s milk 3.3g, egg 15g, carp 17g, prawns 21g. Although the protein content of human milk, cow’s milk and eggs is low, the amount of essential amino acids they contain basically matches that of the human body, so they have high nutritional value and are the best foods in the diet. Foods containing more protein include: livestock milk, such as milk, goat milk, horse milk, etc.; animal meat, such as cattle, sheep, pigs, dogs, etc.; poultry meat, such as chicken, duck, goose, quail, ostrich, etc.; eggs, such as eggs, duck eggs, quail eggs, etc. and fish, shrimp, crab, etc.; and soybeans, including soybeans, green beans and black beans, etc., of which soybeans have the highest nutritional value, it is a high-quality source of protein in the food for infants and children; In addition, like sesame seeds, melon seeds, walnuts, almonds, pine nuts and other dried fruit protein content are higher);
② Limit the proportion of vegetable protein intake. Foods high in plant protein such as cereals, hard fruits, almonds, etc.;
③ 1 day of high-quality protein should be evenly distributed to 3 meals, do not concentrate on one meal to eat, in order to facilitate absorption and utilization;
2. High-calorie diet: Ensuring sufficient calories is a guarantee to achieve a long-term low-protein diet.
Daily intake is 30 to 35 kcal/kg body weight. About 2000 to 2500 kcal per day. In addition to protein provision, carbohydrate foods with high calorie content and low protein can be used in the diet as the main source of calories, such as potatoes, yams, taro, lotus root, pumpkin, vermicelli, water chestnuts, lotus root powder, rhizome powder, water chestnut powder, dough powder, etc. Foods high in non-essential amino acids should be limited, such as dry beans (red beans, mung beans, fava beans, fava beans, mao beans, bowl of bean nuts), soy products (tofu, dried beans, soy milk), hard fruits (melon seeds, peanuts, walnuts, cashew nuts, corn seeds) and cereals. There is also the use of fat to provide, but the fat should be less, especially to limit animal fat, cooking should be used vegetable oil.
3, low salt and water restriction: for patients with urine volume above 1000ml without edema can not limit the amount of water intake, with edema and hypertension, heart failure daily should limit the amount of water intake, salt intake of 3g / d, without the above-mentioned cases of salt can be appropriate into 4-6g / d.
4, low potassium diet: uremia period generally have high blood potassium, to strictly limit the intake of potassium (high potassium food are fresh fava beans, horse bell Department, yam, spinach, amaranth, kelp, purple cabbage, black dates, apricots, almonds, bananas, walnuts, peanuts, green beans, soybeans, mung beans, mao beans, sheep loin, pork loin, etc.).
5, low phosphorus diet: shall be very low phosphorus diet. High phosphorus content (dry bean seeds and nuts, animal offal, bone broth, etc.), potassium food can be cooked to potassium (such as boiling to soup), fruits with sugar and then boiled to discard water.
6, calcium supplementation: kidney failure patients are often high phosphorus and low calcium, generally can take oral calcium carbonate.
7, supplementation of vitamins: general water-soluble vitamin B (especially vitamin B6, folic acid), vitamin C deficiency, need to supplement.
8, supplementation of trace elements: general kidney failure patients often lack of zinc, iron. Lean lamb and lean beef are rich in iron and zinc, and lotus root powder is rich in iron.
9, emotional stability, sleep enough, keep the bowels open.