Bed rest is required for those with severe edema and hypoproteinemia. The daily intake of high quality protein is 0.6 g per kg of body weight, ensuring sufficient calories (about 1500 calories). A high-protein diet is not advocated. A low-salt (3g/day) diet should be used for edema, and a salt-free diet should be avoided. A diet rich in saturated fatty acids (animal fats) should be consumed sparingly, and a diet rich in polyunsaturated fatty acids (such as vegetable oils, etc.) and soluble fiber (such as vegetables, oats, rice bran, etc.) should be consumed more often. Limit potassium and phosphorus intake in renal insufficiency. Patients with nephrotic syndrome are often restricted by diet and the presence of long-term hormone use, so they need appropriate exogenous calcium supplements, commonly used are rocalciferol and calcium carbonate vitamin D3 tablets (Geerchief D, Diquor, etc.).
Specific dietary requirements for patients with nephrotic syndrome.
Reminder: Many patients try to replace lost protein by eating large amounts of protein-rich foods or even supplements, which is wrong! In fact, because the disease has not yet remitted, the high protein diet causes hyperfiltration of the glomerulus, hypoproteinemia cannot be effectively corrected, and urinary protein increases instead, further deteriorating kidney function. Therefore, the protein intake should be moderately reduced under the condition of adequate caloric supply, and attention should be paid to the use of foods rich in high quality protein. For example, eggs, fish, chicken, meat, dairy products, and forbidden to eat tofu, soy milk, soybean skin and other soy products. In addition, nitrogen retention, renal insufficiency, protein intake should be further reduced.
2.Appropriate restriction of fat supply.
Patients should limit fat intake appropriately: ① Use vegetable oil when frying, do not consume animal oil and cholesterol-rich animal offal, squid, egg yolk and fatty meat. ②Increasing the intake of dietary fiber can also lower blood lipids. Coarse grains and vegetables and fruits all contain more dietary fiber.
3.Appropriately increase carbohydrates to ensure sufficient energy.
Adequate daily intake of calories is very important to maintain your good nutrition and health. Almost every kind of food people eat contains protein, fat and carbohydrates, and each 1 gram of these three nutrients is metabolized by the body to produce 4, 9 and 4 kcal of calories respectively. If the calorie intake is not enough, it will consume body fat and even muscle tissue, leading to malnutrition. Too much intake will lead to obesity and increased blood lipids in the body.
When you have chronic kidney disease, you are told to reduce dietary protein so that there are many calories also reduced at the same time, and the calorie deficit part needs to be supplemented with carbohydrate-rich foods, such as potatoes, sweet potatoes, yams, vermicelli, lotus root flour, wheat starch, etc. These foods contain almost no vegetable protein, but contain very high calories almost the same amount of calories as in the same amount of flour. You can also add vegetable oils rich in monounsaturated fatty acids: olive oil, tea seed oil, for diabetics will not cause an increase in blood sugar, is conducive to lowering blood lipids. Many patients often have a poor appetite, food varieties should emphasize diversity, color, flavor and shape, in order to enhance the patient’s appetite.
4, limit the intake of sodium.
Patients with chronic kidney disease must control salt intake: it is now recognized that patients with hypertension and kidney disease should control the intake of salt. Internationally recommended daily dietary sodium intake is less than 6 grams, generally normal diet even without adding sodium-containing condiments food has about 3 grams of salt, which means you only need to add 3 grams of sodium-containing condiments to your diet every day. The amount of sodium intake should also be adjusted according to the patient’s edema, serum protein and blood sodium levels.
When edema is evident, abstain from sodium-rich foods: such as pickled vegetables, salted fish and other pickled products, salt-containing condiments like soy sauce, barbecue sauce, MSG, many canned foods and frozen food processed meats like ham, bacon, smoked sausage and cold cuts, sodium-rich snacks like baked potato chips, restaurant and take-out food, canned chicken and broth, alkaline-containing staples (baked buns, etc.), sodium-rich vegetables like white radish, spinach, cabbage, rape, etc.
5. Control the intake of water.
If you have obvious edema, you should limit the amount of water intake. The amount of water intake is usually 500~800ml added to the previous day’s urine volume.
Note: Water here refers to all fluids that enter the body such as food, fruits, drinks, and infusions. Salt intake is accompanied by water intake, to control the water intake must eat less salt.
6.Increase or limit potassium intake.
According to the blood potassium level and urine volume, supplement potassium preparations and potassium-rich food in time. Due to the use of diuretics, as a large amount of urine is excreted, the excretion of potassium also increases, which can easily lead to hypokalemia. Therefore, potassium-rich foods, such as vegetables and fruits, citrus, bananas, dates, etc., should be supplemented appropriately.
If the urine output is low or the blood potassium is high, the intake of potassium-rich foods should be limited. Such as seafood, mushrooms, ham, fungus, dried fruits, apricots, cornflakes, bananas, citrus, potatoes, juice, vegetable juice, spinach, amaranth, tomatoes, dried radish, tea, soy sauce, MSG, etc. Green vegetables can be scalded with boiling water before frying (to remove potassium).
7, adequate vitamins and minerals.
A large amount of proteinuria makes calcium deficiency, which can easily lead to osteoporosis and hypocalcemia. Your doctor may give you some drugs such as calcium and vitamin D. Note that these drugs must be used under the guidance of a doctor. Also maintaining a balance of calcium and phosphorus will prevent loss of calcium from your bones and you will need to limit phosphorus rich foods.
Foods high in phosphorus such as: dairy products such as yogurt, fresh cow’s milk, cheese, pudding, ice cream, etc.; various legumes milk fava beans, peas, lentils, nuts such as peanuts, melon seeds, etc., drinks such as cola and other black drinks, beer, etc., and tea, mouth grinding, mushrooms, animal offal, shrimp (shrimp skin), sesame paste, etc.
Relatively low phosphorus content of foods such as: fresh vegetables, fresh fruit,, wet kelp, chicken, eggs, potatoes, yams, taro, sweet potatoes, etc. Foods rich in protein are often high in phosphorus as well, and after reasonable control of dietary protein, dietary phosphorus intake is reduced accordingly.
Since diuretics are often used in clinical treatment, resulting in the loss of large amounts of B vitamins and vitamin C. Therefore, vegetables and fruits rich in vitamin C, coarse grains and nuts rich in vitamin B1, dairy rich in vitamin B 2, etc. should be consumed, and preparations such as vitamin C and B vitamins should be supplemented when necessary.