Diet therapy for patients with chronic kidney failure

1, protein intake Chronic renal failure (CRF) patients have a series of metabolic disorders in the body, protein and amino acid metabolism disorders are particularly obvious. Studies have confirmed that low protein diet (LPD) can not only reduce the production of protein metabolites in the body and reduce the symptoms of toxicity, but also reduce the burden on the kidneys, slow down the deterioration of renal function and reduce proteinuria. Protein selection: It is generally believed that animal protein with high biomass content of essential amino acids can correct the deficiency of essential amino acids in the body, and its nutritional value is higher than that of vegetable protein, which is more suitable for patients with chronic renal failure. Animal protein contains more essential amino acids (EAA), which can be easily absorbed and utilized by the body and should be used more often; plant protein contains more non-essential amino acids (NEAA) and should be eaten less or not as much as possible. 2, electrolytes Phosphorus: hyperphosphatemia is a very common and serious complication of CRF, with an incidence of more than 50%. Hyperphosphatemia is also the root cause of secondary hyperparathyroidism (SHPT) treatment failure in dialysis patients and can increase mortality in dialysis patients. There is a large amount of phosphorus in the diet and limiting dietary phosphorus intake is extremely important for blood phosphorus control. People with end-stage CRF should develop a low-phosphorus diet that limits phosphorus in food to 0.6-1.0 g/d. In the presence of hyperphosphatemia, daily phosphorus intake should be limited to 600 mg. Try to avoid phosphorus-rich foods such as dried beans, fresh beans, dried fruits, asparagus, lotus greens, mushrooms, shiitake mushrooms, yeast, poultry, fish, and livestock meat. Calcium: When the kidney function is reduced, the kidney synthesizes 1,25(OH)2D3 and the ability to excrete phosphorus is reduced, resulting in hypocalcemia. Calcium intake should be supplemented in the diet to complement the active vitamin D therapy. However, attention should also be paid to the development of hypercalcemia. Potassium: Potassium-containing foods should be regulated according to body potassium levels to avoid hyperkalemia. Patients with hyperkalemia should be supplemented with foods containing high levels of potassium, such as red dates, bananas, squash, citrus, fresh mushrooms, etc. 3, water intake In kidney failure, the kidneys cannot regulate water metabolism normally and must be regulated artificially to maintain the balance in the body. Too much water intake will increase the cardiovascular and renal load, leading to edema and heart failure; too little water intake, and prone to blood volume deficiency, reduced urine volume, affecting the metabolic waste clear. Therefore, to master the amount of water intake. The principle is the amount of out for in. General early urine volume is normal, you can not need to strictly control the amount of water intake. For patients with CRF with little urine, edema and hypertension, water intake should be strictly limited. Generally 24-hour water intake (including infusion, feeding, etc.) = previous day’s urine volume + 500mL + dominant water loss. The change of body weight is the best indicator of fluid balance, and the increase of body fluid can be reflected directly by measuring body weight. 4.Limit salt intake Excessive salt intake is one of the causes of elevated blood pressure and edema, and also increases the burden on the kidneys. Therefore, CRF patients should be fed a low-salt diet, with a daily salt intake of no more than 5g in the absence of edema and hypertension, and no more than 3g in the presence of edema and hypertension. 5. Reasonable distribution of diet The survey also found that many patients had an unreasonable distribution of food among the three meals, which showed that animal food was too concentrated, so that dietary treatment could not achieve the desired effect. Therefore, in addition to the daily nutritional intake, the specific distribution of food for three meals should be given according to their dietary habits and treatment requirements. 6.Low-glancing diet: Applicable to hyperuricemia and gout. (1) The daily dietary intake of glancing purine should be <150mg, so avoid eating liver, kidney, brain; sardines and other foods containing high purine, while purine is dissolved in water, do not eat thick chicken juice, meat juice, hot pot juice, and avoid drinking beer. (2) Milk, eggs, fresh fruits and vegetables (except spinach, cauliflower and mushrooms) are optional. (3) Since most of the patients are overweight, it is necessary to control the total caloric energy, 25-30 kcal/kg per day by standard weight is appropriate. (4) Give low-fat diet to reduce caloric energy and promote the excretion of endogenous uric acid. (5) Moderate control of protein, generally 0.8-1 g/kg body weight, to reduce the formation of exogenous uric acid. (6) Patients should be encouraged to consume more water to facilitate uric acid excretion.