There are 6 nutrients that kidney patients on hemodialysis must supplement. Check to see if you have supplemented enough?

Long-term dialysis not only excretes waste from the body, but also causes the loss of certain nutrients such as vitamins and proteins in the body, leading to malnutrition in dialysis kidney patients.

Therefore, patients undergoing long-term dialysis must pay attention to nutritional supplementation, especially the following nutrients, which are indispensable!

What nutrients do long-term dialysis patients need to supplement?

1. Protein

Protein is the material basis of life activities, but a large amount of protein will be consumed or lost during dialysis, so it is necessary to supplement protein appropriately. If you receive dialysis three times a week, the daily protein intake per kilogram should reach 1.0~1.2 grams.

For example, a kidney patient weighs 60kg, and his normal daily protein intake is 60-72g, of which more than 50% is high-quality protein, and high-quality protein accounts for 30-36g, which is mainly provided by eggs, milk, fish, poultry, livestock meat and soy products.

Protein content in common foods:

For some vegetarians, eggs, tofu or soy products can be chosen; if conditions permit, protein nutritional supplements can be chosen.

2. Energy

Energy comes from 3 macronutrients: carbohydrates, protein and fat.

The "Guidelines for Clinical Practice of Nutritional Therapy for Chronic Kidney Disease in China (2021 Edition)" recommends that the calorie intake of maintenance hemodialysis patients should be 35kcal. The calorie intake can be reduced to 30~35kcal for patients over 60 years old, those with low activity level and good nutritional status (serum albumin>40g/L, SGA score A).

A comprehensive assessment is needed based on age, gender, physical activity level, body composition, target weight, comorbidities, and inflammation levels.

To assess whether you have insufficient energy intake, please refer to the following table:

The following is a comparison between sufficient energy intake and insufficient energy intake. The results show that people with insufficient energy intake have a significantly increased risk of death related to cerebrovascular disease.

3. Fat

Most patients with uremic kidney disease have hypertriglyceridemia, so they need to strictly limit the intake of saturated fatty acids and polyunsaturated fatty acids to avoid hyperlipidemia. They should not eat or eat less refined sugar, animal oil, and offal.

The intake of n-3 fatty acids and monounsaturated fatty acids can be appropriately increased to protect cardiovascular health.

Fish contains more unsaturated fatty acids, so you can eat more of it.

The specific intake amount can be referred to in the following table: 2-3 times a week, about 1-2 taels each time.

4. Vitamins

During the dialysis process, kidney patients are prone to vitamin deficiencies, especially water-soluble vitamins, so they need to be supplemented in appropriate amounts.

Vitamin C cannot be synthesized in the human body and can only be taken from the outside. It can prevent scurvy and anemia, and can also promote the synthesis of L-carnitine. Vegetables and fruits rich in vitamin B1, vitamin B2, vitamin B6, etc. can be eaten.

However, you need to pay attention to the intake of high-potassium fruits to avoid continued increase in blood potassium. At the same time, choose medical formula foods under the guidance of a doctor to supplement water-soluble vitamins.

5. Minerals

Calcium: In addition to its role in maintaining bone health, calcium also plays a vital role in nerve impulse transmission, muscle contraction, blood coagulation, hormone secretion and cell-to-cell adhesion.

Phosphorus: The key to treating hyperparathyroidism secondary to chronic renal failure is to control the metabolism of phosphorus. An important part of this is to actively control the phosphorus content in the diet, which can also slow the progression of renal failure.

Limit phosphorus intake to no more than 800 mg per day, reduce protein intake, and avoid eating high-phosphorus protein foods.

6. Dietary fiber

Studies have shown that dietary fiber has anti-inflammatory effects, can lower blood creatinine levels, and affect glomerular filtration rate, and can also delay the progression of chronic kidney disease.

The coarse grains, potatoes, vegetables, and fruits that are common in our daily lives all contain dietary fiber. Kidney patients on dialysis with high blood potassium can soak or blanch the ingredients in water before cooking.

Amount of dietary fiber in common foods:

Daily food intake depends on reasonable combination to ensure comprehensive and balanced nutrition. Kidney patients should not always eat staple foods and ignore the nutritional value of other foods.