Hemodialysis patients in the diet, often uncontrolled or there are great misconceptions, first briefly described below, for reference.
1, high-quality protein diet: the process of hemodialysis will lose a certain amount of protein and amino acids, plus dialysis can also promote the decomposition of protein, easy to lead to negative nitrogen balance protein daily intake of 1.2g/kg.d, appropriate, if the protein intake of 1.0g/kg.d, malnutrition will persist. The eight essential amino acids in the human body cannot be synthesized in the body and must be provided by food, so they are called essential amino acids, while the other 12 amino acids can be synthesized in the body and are called non-essential amino acids. Protein in food is divided into two categories: one is high biomass protein. Also known as high-quality protein, can provide the most complete amount and proportion of the appropriate spectrum of essential amino acids, the synthesis of human protein utilization rate is high, resulting in 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, which contains less essential amino acids, such as vegetable protein from rice, noodles, fruits, beans, and vegetables. When choosing protein foods for patients entering the dialysis phase. More than 2/3 are required to be high biomass proteins containing more essential amino acids. These high quality proteins have a higher utilization rate than plant proteins, produce less urea, and are tasty and delicious.
2. Sufficient calories, supply patients with enough calories to reduce the consumption of protein in the body to maintain physiological needs and physical status. Carbohydrates and fats are the main sources of calories, but carbohydrates should be the main source, and there should not be too much fat. Starchy foods contain low protein, especially wheat starch protein content is only 0.4 to 0.6%, should be preferred, in addition, lotus root powder, pumpkin, taro, potatoes, white potatoes, vermicelli and other protein content are very low, can also be selected. Fat can be chosen from fat, cream, butter, lard, vegetarian oil. In the case of a 60 kg weight patient, for example, you can eat 367 grams of starchy food per day, about a little more than 7 taels, 35 grams of vegetable oil and 35 grams of animal fat.
3, low phosphorus diet: the main function of phosphorus is to strengthen bones, uremic patients because the kidneys can not work properly, so excess phosphorus will accumulate in the blood, resulting in hyperphosphatemia, leading to skin scratching, secondary hyperparathyroidism and bone lesions. Foods high in phosphorus include dairy products, soft drinks, colas, enzymes, offal, dried beans, whole grains (brown rice, whole wheat bread), eggs, dried fish, etc. You should also be careful to avoid eating too much. Boil lean meat and fish in water and remove the broth before consumption, which will remove some of the phosphorus. If necessary, take oral phosphorus binding agents. 4, increase the intake of iron and folic acid is beneficial to improve renal anemia, standardized application of erythropoietin.
5, low potassium diet: when renal insufficiency, the body can not effectively remove the excess potassium, and too high blood potassium can cause serious heart conduction and contraction abnormalities, and even death. Therefore, you should consume less vegetables (such as mushrooms, mustard, cauliflower, spinach, etc.) and fruits (such as loquats, peaches, hard persimmons, oranges, etc.) with high potassium ion content, and drink less tea.
6, low sodium diet: too much salt in maintenance dialysis patients can lead to thirst and excessive drinking, which can lead to hypertension or edema. For maintenance dialysis patients salt intake is generally 3-5g/d, and sodium intake for anuric patients should be even less. Avoid high sodium food intake, such as pickled vegetables, salted eggs, sauce and various kinds of pickled foods, put less salt in stir-fry, and consume less soy sauce, MSG, ketchup, salsa, vinegar, etc.
7.Limit water intake: weight gain during the interdialysis period should be less than 4-5%.
8.Improve the patient’s appetite: take measures to improve the patient’s appetite, such as appropriately increasing the amount of activity, providing colorful, fragrant and tasty food, providing a comfortable and neat environment, and having small and frequent meals.
9. Test relevant indicators and assess nutritional status: Regularly test blood routine, renal function, electrolytes, and parathyroid hormone to adjust medication. Observe the patient’s weight change, serum albumin and hemoglobin level, etc. to understand the nutritional status. Pay close attention to blood pressure changes, etc.
Attachment: table of commonly used foods containing phosphorus, [Note: unit, mg/100g,]
1., Cereals.
Flour, gluten, 35, oil, bar, 79, high gluten flour, 175
Rice, flour, 37, noodles, thread, 87, brown, rice, 280
Noodles, (cooked), 42, low gluten flour, 96, small, wheat, 405
Rice, (cooked), 51, nutritional flour, 112, oat, wheat, 451
Noodles, bread, 67, glutinous, rice, 120, camp, nutrient, rice, 516
2., Fats and oils.
Lard, oil, 0
Peanut, raw, oil, 0
Salad, pull, oil, 0
3., dry bean seeds and solid class
Winter, powder, 30, oil, bean, rot, 230, yellow, bean, 506
Flower, raw, milk, 36, stink, bean, rot, 257, bean, skin, 560
Soy, milk, 40, bean, tofu, milk, 301, fava, bean, 570
Tofu, tofu, 169, red, bean, 318, sesame, hemp, 574
Miso, 170, green, beans, 320, dried, lotus, seeds, 583
Corn, seeds, 191, peas, beans, 387, peanut flour, 777
Yellow, bean, dried, 194, flower, raw, rice, 392, squash, seeds, 984
4., Starchy roots and tubers
X, m, 7
Beans, potatoes, 14
Horse, bell, potato, 58
Water chestnut, shepherd, 72
Lotus, lotus root, powder, 80
Rhizome, horn, 104
Sweet, potato, 110
5. Livestock and poultry
Pig, blood, 11, cow, tongue, 136, duck, meat, 190, pig, loin, 246
Fat, pork, meat, 18, duck, gizzard, 167, goose, meat, 191, sausage, 265
Five, flower, meat, 83, beef, tripe, 170, pork, tongue, 199, beef, liver, 276
Beef (semi-fat), 90, Chinese ham, 171, chicken, meat, 230, chicken, liver, 283
Lean, pork, meat, 123, pork, brain, 177, foreign, fire, leg, 231, pork, meat, pine, 430
Preserved, meat, 128, beef, (lean), 177, pork, heart, 236, beef, meat, liver, 476
Lamb, meat, 134, chicken, gizzard, 181, pork, belly, 240, pork, liver, 521
6., aquatic food category
Seaweed, scallop, 6, clam, clam, 128, carp, fish, 174, river, eel, 240
Sea cucumber, 8, white, pomfret, 137, sailfish, 179, horse, fish, 249
Eel, eel, 54, shrimp, 139, black, pomfret, 184, shark, fish, 257
Clam, boy, 85, sea, eel, 151, wu, fish, 198, small, tube, 257
Oyster, boy, 105, sea crab(y), 153, stripped, robe, 204, fish, pine, 291
Crispy, fish, ball, 115, Wu, Guo, fish, 154, White, scallop, fish, 205, Bed, son, fish, 353
Lice, eye, fish, 123, squid, squid, 156, Guo, fish, meat, 228, nori (dried)
7., vegetables
White, roots, 11, oil, vegetables, 25, hollow, heart, vegetables, 36, mowing, vegetables, 61
Winter melon, 12, loofah, melon, 25, spinach, cabbage, 36, amaranth, cabbage, 66
Cucumber, 18, bitter gourd, 26, Shandong cabbage, 36, gui, bamboo, xun, 71
Mowing, heart, 20, green, bean, sprout, 28, leek, flower, 38, red, phoenix, cabbage, 76
Green, pepper, 21, green, bamboo, xun, 30, leek, vegetable, 41, white, amaranth, vegetable, 80
Green cabbage, 22, eggplant, 30, carrot, radish, 42, tomato, potato, leaf, 81
Cauliflower, 22, Cauliflower, 30, Min, bean, 44, Jade, marsh, millet, 100
Lagenaria, melon, 23, lettuce, lettuce, lettuce, 30, lettuce, 45, mushroom, 120
Celery, lettuce, 23, pumpkin, 30, bamboo, bamboo shoots, 49, beans, 140
Chrysanthemum, lettuce, 23, leek, yellow, 31, vegetable, bean, 54, mushroom, 190
Tomatoes, eggplants, 24, onions, 33, bamboo shoots, 55, golden needles (dried), 208
Small, cucumber, 24, wild rice, white, bamboo shoots, 35, mustard, blue, vegetables, 56, wood, ear, 210
8., fruit category
Eggplant, honey, melon, 6, red, watermelon, 11, red, wen, dan, 19, dip, persimmon, 27
Yellow, watermelon, 7, barrel, tangerine, 15, white, wen, dan, 20, lychee, 27
Mango, fruit, 8, poplar, peach, 16, bird, pear, 20, Portugal, grape, 27
Pineapple, pear, 9, water, pear, 17, white, pomelo, 21, peach, boy, 38
Apple, fruit, 10, Fragrant, melon, 17, Papaya, 22, Longan, eye, 42
Tomato, pomegranate, 10, mandarin, 17, lotus, mist, 23, red, date, 42
Loquat, 10, red, persimmon, 18, lemon, lemon, 23, sakura, 49
Red, grapefruit, 10, plum, seed, 19, fragrant, banana, 24, black, date, 128
9., eggs and dairy
Chicken, egg, white, 12, skin, egg, 198
Fresh, human, milk, 21, duck, egg, 232
Fresh, cow, milk, 85, chicken, egg, 238
Fresh, sheep, milk, 110, chicken, egg, yolk, 547
10., Other
Food, salt, trace, black, sugar, 80
Soda, water, 1, soy sauce, oil, 153
Beer, wine, 4, package, seed, tea, 185
Bee, honey, 7, black, tea, 270
Sugar, cane, juice, 9, green, tea, 550
White, vinegar, 16, health, vegetarian, juice, 970
Vinegar, 25, fermented, mother, powder, 1600