Eating Right For Chronic Kidney Disease

Can't eat bananas, dare not touch vegetables...

Grandma Li has heart disease, high blood pressure and diabetes at the same time. She implements a low-fat, low-sugar, and high-fiber diet for patients with three highs, and is a good patient in the eyes of doctors. But since she was found to have mild kidney disease (high proteinuria), Grandma Li took her family into eating disorder and hysteria:

●I used to eat a banana or a kiwi every day to take care of her heart, but she is afraid to eat it now, for fear that the potassium in bananas and kiwi will worsen her kidneys.

●I used to eat green vegetables every day, but now I hope the vegetables change face, and I think the potassium in the vegetables will definitely make her kidneys worse.

●She doesn't allow her family to buy all the five kinds of bread and steamed buns. She even throws away the whole package of brown rice. She thinks that they are high in protein, and she is worried that proteinuria will be more serious...

Grandma Li dared to eat less and less food. Finally, she was sent to the emergency room. The doctor said that she did not eat or drink, which caused her body to become dehydrated. Instead, her blood potassium was too high, which turned into acute renal failure and caused arrhythmia.

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Kidney patients often have other chronic diseases such as diabetes, hypertension, etc., or it should be said that these three may be cause and effect of each other.

The kidney is composed of millions of microvascular globules, but high blood pressure will gradually harden the blood vessels, and high blood sugar will also accelerate the hardening of the blood vessels, reducing the blood flow supplying the kidneys, and the kidney function will decline rapidly; therefore, if diabetes and high blood pressure Good control of blood sugar and blood pressure in patients with blood pressure will help protect kidney function and delay the process of kidney deterioration. Physician of the Department of Endocrinology and Metabolism at the Tri-Service General Hospital, mentioned that about 40% of dialysis patients are caused by diabetic nephropathy.

On the other hand, kidney function is mainly to maintain the normal composition and volume of blood throughout the body, excrete wastes produced by metabolism in the body, and also release renin and angiotensin to regulate blood pressure, so the normal function of the kidneys also helps maintain Stability of blood pressure and blood sugar.

In addition to taking medicine to control, "how to eat?" often makes patients and their families feel at a loss, because different chronic diseases have different dietary principles, and some of them conflict with each other.

The principles of disease diet contradict each other, what should we do with chronic kidney disease patients?

Let's first compare the dietary principles of the three diseases:

Diabetes diet

A diabetic diet emphasizes the "balanced" intake of six types of food - such as a fixed amount of sugar at each meal, small and frequent meals to control blood sugar; high fiber such as whole grains, vegetables, etc. can increase satiety, slow down sugar absorption; low oil, Low-fat can control weight and fat accumulation to maintain health.

Hypertension diet

The high blood pressure diet emphasizes the "three less and two more principles" ─ low fat, less condiments, less processed products, more fruits and vegetables, and more fiber; especially fruits and vegetables with high potassium content can help reduce blood pressure; use less Condiments, eat less processed products, in order to reduce salt intake, to avoid high sodium content.

There is a "DASH diet (DASH)" for high blood pressure, which also advocates increasing the intake of whole grains, fish, skinless poultry, and nuts, while eating less red meat, and sugar-sweetened beverages, and sweets, and at the same time taking into account protection. Cardiovascular function.

Kidney diet

The main principles of the kidney diet are four lows—low protein, low sodium, low phosphorus, and low potassium. Among them, the biggest dietary change is low protein. Before dialysis, the protein intake is about 0.6-0.8 g/kg body weight a day; after dialysis, it is slightly higher, about 1-1.2 g/kg body weight; Dietary intake is adjusted based on blood biochemical values.

Seeing this, you may have seen many contradictions. For example, whole grains are suitable for patients with diabetes and high blood pressure, but they are not suitable for kidney patients due to their high phosphorus and potassium ions. The intake of vegetables and fruits is also easy to cause kidney disease. The patient's blood potassium content is too high; nuts are suitable for high blood pressure patients, and even the famous "heart" food, but it is a high phosphorus food, and kidney patients must avoid it, but his heart disease requires potassium and phosphorus to take care of... what to do with this?

If the blood biochemical index is normal, there is no need to avoid it

Modern nutritionists soothe their patients do not need to be too nervous for that.

Vegetables are blanched and then fried, do not drink vegetable soup, you can reduce the intake of potassium. Two servings of fruit a day should avoid star fruit because it contains a certain neurotoxin, which will cause uremia patients to continue to have hiccups and other symptoms, and may convulse and coma in severe cases.

In addition, be careful about the potassium content in healthy food and Chinese herbal medicine. Many patients are afraid to tell the doctors what healthy food or traditional Chinese medicine they are taking, but they are always worried about why the index does not come down.

For kidney patients with high blood pressure or congestive heart disease, white vinegar can be used instead of black vinegar, and spices can be used to reduce the use of salt, but the most important thing is to avoid using low-sodium and thin-salt soy sauce, because these products Just replacing the "sodium" in the salt with "potassium" is self-defeating, causing the patient's blood potassium to be too high, which may seriously lead to arrhythmia and even death.

Basically, the intake of calcium, phosphorus, and potassium is contraindicated. It depends on the patient's blood biochemical values and then makes individual adjustments. "As long as your potassium, phosphorus, and calcium ion indexes are normal, it means that the current diet content and frequency can also allow the kidneys to metabolize normally. , you can continue to maintain it, and don’t pay too much attention to the content of the health education leaflet.” However, Yang also reminded that the values must be checked regularly, and if there is any change, the frequency of eating and the amount of intake should be adjusted.

Low protein or eat meat, eggs, beans

The most troublesome thing for kidney patients is how to practice "low protein"? Many patients think that not eating meat and eggs is low protein, but they are wrong. The hospital nutritionist explained that meat and eggs are instead high-quality protein sources. Under the control of protein, more than 1/2 to 2/3 should still come from high-quality protein (animal protein), and others include milk, fish, etc., because it is the human body. The use of high-value protein can reduce the production of nitrogenous waste and reduce the burden on the kidneys. On the contrary, such as pasta, red beans, mung beans, nuts, and gluten products, which are of low physiological use value, the amount must be controlled.

In fact, among the staple food choices, winter noodles, rice noodles and other protein content are less, and they can also be eaten instead.

There are still rumors that people with poor kidneys should not eat soy products. Research has confirmed that this is a misconception. The nutritionist explained that the experiment was done with rats at first, but later it was found that the absorption and utilization of soybean protein in rats and the human body are different. Therefore, for the human body, soybean is a high physiological value protein, so it is edible.

Especially for diabetic patients with kidney disease, the principle of low-protein diet should be paid more attention. The American Diabetes Association revised the protein restriction for diabetic patients, proposing that the ratio of protein-calorie sources to total calorie ratio should be less than 20%, in order to reduce the burden on the kidneys and reduce the risk of chronic kidney disease.

Nutritionists remind that the nutritional supplements that diabetic patients often eat should also be included. Many patients ignore the protein content of nutritional products, and if they consume it for a long time and exceed the limit, the kidneys will soon be damaged.

In addition, Modern nutritionist offers small tips. The health education leaflet recommends that patients with kidney disease consume an appropriate amount of calories, mainly carbohydrates and fats; but diabetic patients with kidney disease at the same time must control their intake of total sugar. The sources of sugar include staple foods, vegetables, Fruits, and then control the protein according to the situation of kidney disease. However, because calorie needs are also considered, some low-protein starch snacks and drinks, such as Chengfen (gluten-free flour), corn flour, Taibai flour, lotus root flour, winter flour, sago rice, flour balls, etc. Grass, love jade, etc. can be used to supplement heat. Of course, the sugar in it needs to be replaced with sugar substitute, or drink less soup.

the nutritionist also explained that if the calories are too low, the body will begin to break down muscle protein, and nitrogenous waste will still be produced, increasing the burden on the kidneys.

The source of protein is also important. Yang also mentioned that the phosphorus and potassium ions in milk are also high, and low-protein milk powder can be used instead.

A study published in the American Journal of Kidney Diseases also suggested that eating at least two servings of fish per week within the recommended protein intake may protect diabetics with kidney disease because of the omega-3 fatty acids in deep-sea fish. It has anti-inflammatory function, which is helpful for proteinuria caused by nephritis. In addition, it can increase glucose tolerance, reduce fat in the blood, and lower blood pressure. Fish is also a high-quality protein source, which can be said to be good for diabetics and kidney patients. is a good choice. "As long as your cooking method is simple, such as steaming or roasting, you can also avoid high sodium levels," Yang added.

For kidney patients, low protein is the biggest dietary change, but it is not difficult to implement as long as the general principles are mastered.

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