The kidney is one of the most important organs to maintain the relative stability of the body’s internal environment, and the diet of kidney patients, nutritional intake, and the amount of water intake directly affect the condition. So diet is especially important in kidney disease.
1.General rule of diet
Usually need low fat, low salt, high quality low protein diet 0.6-0.8g/kg/d (nephrotic syndrome can be increased outside 0.8-1.0g/kg/d), avoid alcohol and spicy food, less greasy food. Different kidney disease, the diet is also different. Food containing protein is divided into two categories: one is high biomass protein, also known as high-quality protein, which can provide the most complete amount and the appropriate proportion of the essential amino acid spectrum, synthesize the high utilization of human protein and produce less metabolic waste. These foods include egg whites, milk, beef, poultry, pork, fish, etc.; the other category is low biomass protein, also known as non-quality protein, containing less essential amino acids, such as rice, noodles, fruits, beans, vegetables in plant protein.
2.Do I need a low-salt diet?
We normal adults consume about 5-6 grams of salt per day, salt is sodium chloride, too much salt intake, easy to make water retention in the body, inducing edema, so edema patients should control the amount of salt intake, each person into the salt 2-3 grams can. Salt-free diet is also unscientific, and it is easy to be weak and dizzy after a long time. For patients without edema, salt intake can be the same as normal people, but in moderation.
3.Is it necessary to limit water?
Normal people generally urinate 1500 to 2000ml a day, acute nephritis, acute renal failure oliguric phase and nephrotic syndrome, chronic renal failure with oliguric swelling patients, to control the amount of water intake (including the amount of water, food water content and intravenous medication fluid volume). Because drinking in can not be discharged, water retention in the body to aggravate edema, but also easy to aggravate hypertension, at this time the amount of water intake to urine plus 500ml is appropriate. The amount of water intake can be relaxed after the increase in urine volume. And patients with normal urine volume can drink water normally. In addition, patients with urinary tract infections such as acute pyelonephritis, urethritis, cystitis, etc., in addition to timely consultation and medication, drinking more water and urinating more is very beneficial to the recovery of the disease.
Diet for patients with different kidney diseases
I. Nephrotic syndrome.
Patients with nephrotic syndrome are often accompanied by gastrointestinal mucosal edema and ascites, which affects digestion and absorption. It is advisable to have an easy-to-digest, light, semi-liquid diet. In nephropathy, a large amount of urine protein is lost, and the body is in a state of protein malnutrition. At present, a high-quality protein diet of 0.8-1.0 grams per kilogram of body weight per day is advocated. Almost all patients with this disease have hyperlipidemia, limit the intake of animal fat, and supply rich polyunsaturated fatty acids (such as fish oil) and vegetable oils (soybean oil, rapeseed oil, sesame oil) in the diet. For high edema, restrict sodium intake to less than 3 grams of salt per day, and supplement with trace elements appropriately.
Please note the following dietary principles.
1, sodium intake: edema should be into a low-salt diet, so as not to aggravate edema, generally no more than 2g of salt per day is appropriate, prohibit pickled products, less MSG and alkali, swelling subsided, plasma protein close to normal, you can resume the ordinary diet.
2, protein intake: nephrotic syndrome, a large amount of plasma protein excretion from the urine, the human body protein decreased and in a state of protein malnutrition, hypoproteinemia so that the plasma colloid osmotic pressure decreased, resulting in edema stubbornly difficult to eliminate, the body resistance also decreased, so in the absence of renal failure, its early, extreme phase should be given a higher quality protein diet (0.8 ~ 1.0g/kg * d), such as fish and meat. such as fish and meat. This helps to alleviate the hypoproteinemia and some of the ensuing comorbidities. When the urine protein turns negative, the plasma albumin is normal after the shift to a low quality protein diet.
3, fat intake: patients with nephrotic syndrome often have hyperlipidemia, which can cause arteriosclerosis and glomerular damage, sclerosis, etc., so you should limit the intake of animal offal, fatty meat, certain seafood and other cholesterol-rich and fatty foods.
4, trace elements supplementation: due to increased permeability of the glomerular basement membrane in patients with nephrotic syndrome, in addition to the loss of a large amount of protein in the urine, but also the loss of certain trace elements and hormones combined with protein, resulting in the lack of calcium, magnesium, zinc, iron and other elements, should be given appropriate supplementation. Generally can eat vitamin and trace elements rich vegetables, fruits, grains, seafood, etc.
Second, uric acid nephropathy.
Should drink more water to ensure adequate urine volume (more than 2,000 ml per day); control the intake of purine, take low purine ridge etching, daily meat consumption should be less than 100 grams; and should be prohibited from eating lentils, spinach, wine, tea, coffee, animal offal, nuts and other animal and plant foods.
Third, renal insufficiency.
1, non-dialysis patients: mostly seen in chronic nephritis with mild – moderate renal insufficiency. It is advisable to have a high quality low protein diet (0.4-0.8g/kg/d) and try to control the intake of protein. Eat more starch to increase calories.
2, dialysis patients: ensure adequate nutrition and make up for the loss of dialysis, ensure positive nitrogen balance; daily protein is mainly high-quality protein (1.0-1.2g/kg/d).
IV. Chronic nephritis:
It is a group of glomerular diseases caused by a variety of causes. The disease has a long course, many types, and diverse clinical symptoms, ranging from asymptomatic (only abnormalities are found during routine urinalysis) to marked hematuria, proteinuria, swelling, and hypertension. It is because of the many types of the disease and the complexity of the clinical manifestations that dietary therapy must be differentiated and arranged according to the patient’s renal function.
In light cases without renal impairment, a balanced diet with slight salt restriction is sufficient. However, if there is more urine protein loss or low plasma protein, but the blood creatinine and urea nitrogen are not high, the amount of protein in the diet can be increased appropriately, but not too much, 0.6-0.8g/kg*d is appropriate. The high protein diet is not good for chronic nephritis, it will increase the burden on the kidneys and accelerate the deterioration of kidney function.
2, chronic nephritis hypertensive type of patients, in order to control blood pressure, salt intake should be limited to the condition given to the less salt diet.