After years of clinical experience, the current consensus is that when the patient’s renal function in the early and middle stage of damage, that is, the glomerular filtration rate (GFR) is greater than 25 ml / min or so, the protein intake of about 0.6 grams per kilogram of body weight per day is more appropriate, and at the same time must be supplemented with adequate calories. In recent years, some people also advocate supplementation of essential amino acid preparations or α-keto acid amino acid preparations. However, the price of such preparations is high, limiting the scope of its use. In the low-protein diet, to high-quality protein-based, such as milk, eggs, fish and lean meat, dietary calories must be sufficient. The minimum is 35 kcal per kilogram of body weight. How to increase the amount of high-quality protein and decrease the amount of plant protein in the diet, nowadays the clinic often uses wheat starch as the main source of caloric energy. Corn starch and potato starch can also be used instead of rice and flour. Because of the low plant protein in starch, each 100 grams contains 0.4 to 0.6 grams of plant protein, while the plant protein in flour is 6 to 10 grams per 100 grams. Clinically, plant proteins will be saved to be supplemented with animal proteins such as eggs, milk, lean meat, etc., so as to meet the physiological needs of the body. This can meet the caloric needs, on the other hand, can also correct the body’s amino acid metabolism abnormalities. In addition to starch, the diet can also be used as the main source of calories, low protein foods as the main source of calories, such as potatoes, yams, taro, groundnuts, lotus root, pumpkin, fans, water chestnuts, lotus root powder, rhododendron powder, water chestnut flour, powdered dough and so on, containing non-essential amino acids should be limited to food, such as dry legumes, soybean products, hard fruits and cereals, and so on. (1) Protein intake Some clinical laboratory values are listed as follows: Chronic renal failure limited protein intake standard (GFR) Serum creatinine (Scr) Blood urea nitrogen (Bun) Protein intake Renal insufficiency 20～40 <4 (353.6) <40 (14.28) 0.7～1.0 Early uremia stage 10～20 4～8 40～80 0.5～0.6 Uremia stage 5～10 8～12 80～120 0.4～0.6 Advanced uremia stage <5 >12 >120 0.3～0.4 Note: Protein restriction in advanced uremia is strict. Only short-term is appropriate, and other measures should be taken after 1 to 2 weeks. For pediatric patients, due to growth and development factors, it is best to limit protein to no less than 1.0 to 2.0 g/kg body weight/day for these patients. High-quality proteins should account for more than 50% of the total. Calories must be supplied adequately. Frequent observation of blood urea nitrogen changes can determine whether the quantity and quality of the supply is appropriate. (2) Essential Amino Acid Diet One of the advances in dietary treatment of uremia in the last decade is that when the deterioration of renal function can no longer be maintained with a high-biomass, low-protein diet, it is necessary to lower protein intake and add essential amino acid preparations. Commonly used dosage forms include powder, tablet, syrup, etc., which can also be supplied intravenously. Powder can be made into various snacks with wheat and corn starch. Patients with chronic renal insufficiency have a low percentage of plasma essential amino acids and a high percentage of non-essential amino acids. Some scholars have found that the above diet is well utilized and easy to obtain nitrogen balance. It has been suggested that oral administration of essential amino acids promotes hepatic protein synthesis and intravenous administration promotes muscle synthesis. With essential amino acids, protein intake is lower than that of a high-biomass, low-protein diet, which can satisfy the body’s need for essential amino acids, make it easy to obtain nitrogen balance, and reduce nitrogen metabolites; at the same time, it can reduce phosphorus intake, so it can alleviate the damage caused to the renal units by calcium deposition. In addition, the choice of protein is not limited to high biological value protein, which is conducive to regulating the patient’s taste, so that the patient is more acceptable. (3) supply of caloric energy The supply of caloric energy must be adequate in a low protein (30-50 g/day) diet. The ratio of calories to nitrogen should be 300-450 kcal:1 g. The daily intake of calories should be at least 35%. The minimum daily caloric intake is 35 kcal/kg body weight. The daily caloric intake should be at least 35 kcal/kg of body weight, or about 2,000 to 2,500 kcal per day. (4) Sodium and potassium If edema and hypertension (diastolic blood pressure greater than 110 mm Hg) are present, sodium should be limited to 40 mg equivalent/day (920 mg/day) (equivalent to a salt-free diet). If the patient is taking diuretics, or with vomiting or diarrhea, sodium should not be limited, and even need to be supplemented. If the patient has hyperkalemia, the intake should be less than 40-60 mEq (1560-2340 mg) per day. Potassium intake should not be restricted if the daily urine output is greater than 1,000 mL and the potassium level is normal. Potassium-restricted diets should avoid fruit juices and carefully select vegetables and fruits. If the patient’s daily urine output increases and is greater than 1500 mL, blood potassium levels should be observed and potassium supplementation should be given if they are too low. (5) Calcium and phosphorus, magnesium When the glomerular filtration rate is reduced to 40-50 ml/min, the excretion of phosphorus through filtration is reduced, resulting in elevated blood phosphorus. If renal function further deteriorates, the elevation of blood phosphorus can not be controlled, high blood scales and renal parenchyma damage so that the kidney synthesizes active vitamin D ability to reduce blood calcium concentration, inducing osteoporosis. The ideal therapeutic diet should increase calcium content and decrease phosphorus content. Calcium-rich foods include milk, green leafy vegetables, sesame seed paste and so on. However, sometimes due to the complexity of the disease is difficult to achieve the ideal purpose, the clinic is generally in accordance with the routine, to supplement the adjustment of pharmaceutical preparations. For example, in adults, when the glomerular filtration rate (GFR) is 2 0 to 25 ml/min, the patient is given 1 to 2 grams of oral calcium (e.g., calcium carbonate, calcium lactate or sodium citrate) daily. To reduce intestinal phosphorus absorption, give the patient oral aluminum hydroxide or aluminum carbonate latex to combine with phosphorus for excretion. The standard for managing phosphorus intake in the diet is that when the patient’s glomerular filtration rate (GFR) is less than 25 mL/min, the daily phosphorus content of the diet should be 45 to 52 milliequivalents (700 to 800 milligrams). Aluminum hydroxide emulsion should also not be discontinued. Patients with chronic renal failure also inhibit magnesium absorption due to prolonged dietary restriction or secondary hyperparathyroidism, when magnesium may be in equilibrium. However, when the patient urinates less, if there is a large amount of magnesium load will be difficult to discharge from the body, excess magnesium in the body may produce high blood magnesium, at this time should limit the intake. (6) Fluid and water balance It is very important for the patient to grasp the balance of fluid intake and output. Generally depending on the amount of discharge to determine the amount of intake. Excretion throughout the day, including urine, respiratory and skin evaporation and digestive fluids. Generally through the skin, respiratory water loss of about 700 ~ 1000 ml per day, and food into the body after metabolism can also produce some water about 300 ~ 400 ml per day, the two are subtracted from the total water loss of about 500 ml per day in addition to the discharge of urine. Therefore, the patient’s daily fluid intake depending on the previous day’s urinary output plus about 500 milliliters of water as a reference for supplementation. However, if the patient has fever, vomiting, diarrhea and other symptoms, more fluid should be added. When the overall condition has been relieved, the daily fluid intake can be around 1200 ml. (7) Vitamin supplementation The level of water-soluble vitamins in the patient’s body will decrease due to metabolic abnormalities and insufficient nutritional intake, and the synthesis of active vitamin D will be affected due to abnormalities in the metabolism of calcium and phosphorus, so the supplementation of various vitamins is very important to the patient. (8) Carbohydrates and fats About 40% to 60% of patients with chronic renal failure have type IV hyperlipidemia (sugar-induced hypertriglyceridemia), which is not only due to endogenous factors, but also related to the high proportion of carbohydrates and fats in the therapeutic diet. Atherosclerosis is induced by disorders of fat metabolism. Therefore, attention should be paid to the ratio of unsaturated to saturated fatty acids (P/S) in the fat supply. Some scholars believe that under a certain calorie supply, the P/S value of 1:1.5 is better. Vegetarian oils are preferred. In conclusion, the diet of chronic renal failure should be low salt, low protein, high calorie, appropriate trace elements and vitamins diet, together with traditional Chinese medicine treatment can slow down the process of renal failure, and can reduce or delay the time of hemodialysis for renal failure.