Nutrition Questions About Dialysis

What complications does a kidney patient suffer from? If he does not follow the nutritional care, he will have problems. What changes will the kidney failure cause in these people? How should protein consumption be done by these people? What are the recommendations of nutritionists in this field?

The issue of kidney failure and its relationship with diet is an important and complex issue, and adjusting the diet of a person with kidney failure must be done by a nutritionist. The nutritionist first determines the patient’s energy needs according to their age. Kidney patients often have limited protein intake and their protein intake must be adjusted to a certain level. More than 70% of the protein intake of a person with kidney failure who is on dialysis is usually made from high quality protein.

  • What does high quality protein mean?

That is, proteins whose amino acid composition is more in line with the body’s needs, such as egg white and milk protein.

  • That is, meat will be removed from one’s diet and milk and eggs will replace it?

We do not remove meat. Many people equate protein with meat, but protein is also found in other foods such as bread and rice. For example, bread has 3% protein. The nutritionist prescribes a diet based on these amounts, and if the dialysis patient is to receive 80 grams of protein, he or she will first determine the intake from vegetables, fruits, dairy products, and grains, and the rest of the required protein from high-quality protein. Which can also include meat.

That the patient is dialyzed several times a week and the type of dialysis (peritoneal or hemodialysis) affects his diet and should be considered. The problem for some dialysis patients is exacerbated by other complications such as diabetes, hyperlipidemia, and systemic inflammation. Intake of phosphorus, potassium and sodium must also be accurately estimated. Some of these patients may also need to lose weight, which should be taken into account. All of these should be evaluated in a relatively long consultation session and eventually implemented into a workable diet plan.

  • Kidney patients have limited protein intake, how is the amount of protein they need calculated?

The amount of protein required in the first stage is estimated according to the amount of function left from the remaining kidney according to the biochemical tests (BUN and creatinine) of the person and the clinical condition and type of dialysis. There are several ways to do this, one of which is based on weight. Because in patients with kidney failure, the actual weight may often not be easily calculated due to swelling and water retention in the body, the result is that weight is calculated using special formulas. In patients who are going to lose weight, we also calculate the amount of protein needed based on the ideal weight. Again, protein restriction does not mean meat restriction. Although meat is high in protein, it is not the only source of good protein. A kidney patient may get too much protein by overeating foods such as whole grains, dairy and legumes, and worsen their condition.

  • Why is a low phosphorus diet recommended for kidney patients and what foods contain phosphorus?

Dairy products, nuts, and meats are sources of phosphorus, and the amount of phosphorus in the diet of kidney patients must be carefully calculated. Although dialysis can correct this problem to some extent, if the diet of a person with kidney failure is not adjusted for phosphorus, there is a risk of increased blood phosphate (hyperphosphatemia) and its consequences. For example, excess phosphate can cause calcium in soft tissues such as kidney failure. Sediment and double the problems.

  • These patients also have limited potassium intake. What foods are low in potassium?

We usually provide patient guidance forms that categorize foods based on the amount of potassium they contain. We also tell them how much low-, medium-, or high-potassium foods they can eat. For example, bananas are fruits that are high in potassium and squash is one of the vegetables that are low in potassium.

  • Kidney patients usually have anorexia. What advice do you have for them to eat better?

Malnutrition is associated with worsening of the disease, and disease control, proper dialysis program, and proper nutrition program help to improve the patient’s condition. People with anorexia are better off eating more meals and eating foods that have a higher nutrient density and lower volume.

  • What can we do to keep our kidneys healthy?

Several important principles are necessary for the complete health of the body, the most important of which are weight control and being as sensitive as the waist. Sometimes people pass this issue very easily and when 2, 3 and 4 sizes become fatter, they buy looser clothes. It is very important to be sensitive to the size of the waist, because abdominal obesity indicates the accumulation of fat in an area that increases the risk of many diseases and can directly or indirectly affect the kidneys. Another issue is controlling sodium intake. Unfortunately, this perspective often causes us to become overwhelmed when it’s time to start eating. Studies have shown that continuous sodium intake, especially if accompanied by chlorine ions (the most well-known example being table salt), can have consequences for the heart and arteries of the kidneys and damage the kidneys. Of course, sodium is abundant in other foods such as sweets and biscuits and processed foods such as sausages, hot dogs and cereals, chips and canned food, pizza and fried chicken. Low consumption of fruits and vegetables, in addition to side effects on various organs of the body such as the gastrointestinal tract, cardiovascular system and immune system; It can also irritate the kidneys in some way. With low consumption of fruits and vegetables, the body is deprived of receiving various antioxidants and anti-inflammatory agents that are present in various vegetables and fruits and have a protective role. We need to bet on eating at least 2 servings of vegetables and 3 servings of fruit a day, and teach that to our children, and that exercise and physical activity should be part of our daily routine.

Related link: Nutritional care in dialysis


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