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Diet in chronic kidney disease


02.06.2015
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Diet in chronic kidney disease


Diet in chronic kidney disease guidelines:

   In chronic kidney disease low protein diet is primarily used. Chronic kidney disease develops as a consequence of kidney disease (damage to the glomeruli or renal tubules), metabolic diseases or long-term kidney stones. Diet in this disease is important mainly to help achieve improved health and nutritional status of the patient, as well as metabolic balance. This allows more effective treatment for dialysis or kidney transplant preparation. Proper diet reduces annoying symptoms of uremia, such as nausea, vomiting, weakness and apathy.



   Diet used in chronic kidney disease is primarily low protein. Toxic products which are derived from protein metabolism, due to their incomplete removal by the kidneys accumulate in the body. Excessive protein intake thus leads to the symptoms of uremia. Protein intake in the diet must be determined individually for each patient, depending on the level of the disease. Indicators such as the urea concentration in the serum and purification factor of endogenous creatinine are used for this purpose. Mostly protein should be limited to about 0.6-1.2 g / kg body weight / day. In extreme cases where there is no possibility of dialysis, it is recommended to limit the amount of protein to 20-25 grams of protein per day. Due to the limited amount of protein in the diet most of the energy supplied should come from fats and carbohydrates. Energy amount provided with the diet is related to the patient's physical activity and any adverse effects from the gastrointestinal tract, which in many cases are associated with loss of appetite. The recommended amount of energy is 30-50 kcal / kg body weight. If the loss of appetite, or frequent vomiting occurs and there is no possibility to provide the minimum recommended amount of energy intravenous supplementation of nutrients is used. Great importance in the diet of patients with chronic kidney failure plays minerals, especially potassium, sodium and phosphorus. Kidneys are responsible for maintaining their proper levels in the body. When they do not work properly, sometimes there is an excessive accumulation of ions, the consequences can be very dangerous. An excess of potassium, leading to heart failure, perhaps even life-threatening, an excess of sodium increases blood pressure, and high levels of phosphorus cause calcium deficiency. Low-sodium diet (sodium intake of  350 mg per day) is necessary when the concentration of sodium in the blood exceeds the 145-148 mmol / L. Excess sodium increases thirst and leads to the formation of edema. Therefore, the amount of sodium in the diet can also be controlled by measuring body weight and blood pressure.



The main principles of the diet

• The amount of fat in the diet compared with healthy human nutrition must be increased to 35-40% of dietary energy content. It is necessary to ensure the large amounts of polyunsaturated fatty acids, which sources are primarily vegetable oils and margarine.
• The ratio of polyunsaturated to saturated fatty acids in the diet should be 2:1. This modification of diet stems from the possibility of lipid disorders occurrence in some people suffering from chronic kidney disease. For this reason, the daily cholesterol intake should not exceed 300 mg. Same as in the healthy human diet most energy should come from carbohydrates: 50-60% of the total amount of energy. The main sources are potatoes, vegetables and fruits.
• Avoid animal fats, which provide mainly saturated fatty acids, such products as lard, tallow, fat species of meat and poultry should be eliminated.     
• Low-sodium diet requires not only resignation from the added salt in preparing food, but also to eliminate all products that are high in sodium. When there is no swelling, and blood sodium level does not exceed specified values, use less salt than in the normal healthy human nutrition.
• Reducing the supply of potassium is necessary if the blood level exceeds 5 mmol / l. Resignation from such products as tomato, cocoa, chocolate and products of its addition, candies, fruit, seeds, legumes, nuts, dried fruits, mushrooms, muesli, cereal, boiled meat and vegetables is necessary. You must also restrict spices such as basil, dried parsley, paprika powder, tarragon, because they contain lots of potassium. Rich in potassium are also meat and vegetables, they should be pre-boiled in water, drained and boiled in water again.
• Advanced uremia often leads to loss of renal phosphorus excretion capacity. This can be very dangerous, leads to hyperparathyroidism, and thus the changes of bone metabolism and reduce the level of calcium. Avoid such foods as meat offal, veal, goose, fish, cereals, cereal, muesli, seafood, legumes, brown bread, soda, instant meals. Dairy products contains a large quantity of the Phosphorus, but because of the high calcium content should not be restricted.
• It is important to check the amount of fluid drunk. You have to sum up the amount of water, remembering that it is also included in soups, dairy products, sauces, etc. The daily dose of fluid is determined depending on the degree of disease.
• Method of cooking should be the same as in the easy to digest diet. So that avoid frying, baking, stewing preceded roast. Food shall be cooked or baked in foil. You can also bake on the grill or pan, which allows to fry without fat.
• Meals should be given an best aesthetically appealing way possible. This has a great importance especially when the disease is accompanied by loss of appetite. To spice up the taste use permitted spices (especially if low-sodium diet is necessary), as well as accentuate the taste, making your food to sour by the addition of citric acid, lemon juice or sour milk.
• Frequency of serving food should be the same as in healthy human nutrition: 4-5 times a day at fixed times.




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