How much do you know about diet for kidney disease

Epidemiological surveys show that the global prevalence of chronic kidney disease (CKD) is about 14.3%, and the prevalence of CKD in China is about 10.8%. CKD has a high prevalence, poor prognosis, and high medical costs, and has become an important public health issue that seriously affects the health of the Chinese people.

Malnutrition is a common complication of CKD and a risk factor for the occurrence, progression, cardiovascular events and death of CKD. Therefore, paying attention to the nutritional problems of CKD patients will help improve the prognosis of patients with chronic kidney disease.

Dietary guidelines for patients with CKD

01. Balanced diet

Ensure adequate energy intake while appropriately limiting protein intake to prevent malnutrition. Choose a variety of foods that are nutritionally sound.

02. Rationally distribute meals at regular times and quantitative amounts. The energy of breakfast, lunch, and dinner can account for 25% to 30%, 30% to 40%, and 30% to 35% of the total energy. Evenly distribute the protein in the three meals. To ensure adequate energy intake, snacks can be added between meals, accounting for 5% to 10% of the total energy.

03. Limit protein intake

CKD patients have reduced kidney function and cannot process excess protein in the body, so they need to reduce their protein intake.

So, what is the recommended protein intake? For patients with chronic kidney disease stage 1-2 , regardless of whether they have diabetes, the recommended protein intake is 0.8-1.0g per kilogram of body weight per day. For patients with chronic kidney disease stage 3-5 who are not undergoing dialysis treatment , the recommended protein intake is 0.6-0.8g per kilogram of body weight per day. For patients on hemodialysis and peritoneal dialysis , the recommended protein intake is 1.0-1.2g per kilogram of body weight per day. At least 50% of this should come from high-quality protein. The stages of chronic kidney disease are as follows:

High-quality protein refers to protein that contains a full range of essential amino acids in sufficient quantities and appropriate proportions, such as protein from animal sources (such as milk, eggs, meat, etc.) and soy protein.

04. Limit intake of high-phosphorus and high-potassium foods

When blood phosphorus levels rise, you should carefully choose animal liver, nuts, dry beans, and various processed foods containing phosphorus.

When blood potassium rises, you should carefully choose fresh fruits, potatoes and their starch, green leafy vegetables, etc.

Common low-phosphorus foods are listed below:

Common low-potassium foods are listed below:

05. Low-salt diet

For patients with chronic kidney disease, dietary sodium intake should not exceed 100 mmol/d (sodium 2.3 g/d or salt 6 g/d).

If the patient has symptoms such as edema, oliguria, and high blood pressure, sodium salt intake should be more strictly controlled.

06. Limit your water intake

Due to the decline of renal function, kidney disease patients will have a decrease in urine volume, so we must control the amount of fluid intake. Fluid intake includes porridge, water, milk, soup, Chinese medicine liquid, etc. It is recommended that the daily fluid intake be 500 ml plus the urine volume of the previous day.

A reasonable diet is very important for patients with chronic kidney disease. Following the doctor's advice and strictly implementing it is of vital importance to improving the patient's nutritional status and delaying the development of kidney disease.

Author: Zhou Ran (Department of Nephrology, China Rehabilitation Research Center)

Reviewer: Ma Yingchun (Department of Nephrology, China Rehabilitation Research Center, Chairman of the Kidney Disease Rehabilitation Committee of the Chinese Rehabilitation Medicine Association)