The Diet in Renal Insufficiency

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Of the major dietary guidelines in renal patients is perceived protein and energy.

The term kidney failure indicates a renal function of the organism and can be divided into acute and chronic forms. Acute renal failure is primarily asymptomatic and diagnosed by increased concentration of urea and creatinine in serum biochemical routine check and by oliguria (daily urine volume <400ml).

The chronic failure however is irreversible most common causes for this condition is diabetes (~ 40%) and hypertension (~ 25%).

When discussing renal insufficiency, the goals of dietary therapy is initially maintaining a good nutritional status, in addition to preventing or minimizing uremic toxicity and waste products of metabolism and finally the delay of disease progression rate.

Therefore all patients with renal insufficiency should be continuously trained in terms of the principles of dietary treatment and the planning and preparation of their diet.

Of the major dietary guidelines in renal patients is perceived protein and energy. Energy intake needed is about 35 kcal / kg of body weight / day in order to maintain good nutritional status of patients [basically weight calculated patient’s dry weight, i.e. the weight not including the water retention or patient’s weight after dialysis].

As regards protein intake, there are several studies that support recommendations ranging from 0.6 to 1 g / kg body weight. Those constitute an chamiloproteiniki diet, are intended to decreased production of nitrogenous metabolic products, which cause and most clinical and metabolic disorders in these patients.

Unlike the studies recommend higher protein intake aim to better nutrition of these patients, regardless of the shortest possible initiation of dialysis. Main sources of protein in the diet are meat and its products, chicken and all poultry, fish, seafood, hunting, egg, milk and legumes.

The intake of potassium and phosphorus also are important for renal patients. Normally the kidneys are the main excretion pathway potassium, but the renal failure can occur retention leading to hypercalcemia.

The hyperkalemia is the most serious electrolyte disturbances, because it can cause cardiac arrhythmias and death from cardiac arrest. Foods rich in potassium are all nuts, enough fruits and vegetables (eg beans, corn, mushrooms, spinach, potatoes, bananas, figs, vegetable juices), chocolate, chocolate drink, coffee, ketchup, the egg, milk and yogurt, and all meat, fish and their products.

As understood not as potassium completely excluded from the diet. However there are ways to reduce the potassium content in some foods. For example, vegetables should be cut into small pieces, be boiled (changing the water first) instead of steamed, in saucepan or microwave.

Thereby significantly reducing the content of potassium. Fruits should always be eaten without the skin, preferably in the form of compost, procedures can significantly reduce the content of potassium.

With respect to phosphorus, it has been found that low intake slows somewhat progression. For this reason often in patients administered phosphate binders of the feed, which reduce its absorption from the gastrointestinal tract.

Food with high phosphorus content are dairy products such as hard, soft and creamy cheeses, milk and egg. Also rich in phosphorus is offal (liver, kidneys), beef, mackerel, sardines, salmon, trout, crayfish, all nuts, chocolate drink and cocoa and the dark refreshments.

In sodium also needs to be limited, and in the ingestible liquids due to their inability excretion by the kidneys. The sodium restriction in the diet does not merely reduce the quantity in the preparation of the food is hidden in many foods indicating that about 85% of the sodium we consume is hidden in other foods and only 15% meet the salt .

Indicatively, foods rich in salt are cheese, bread, crackers, nuts, and it’s packaged in a can. The salt in the food can be replaced with various spices and herbs, that give flavor to food without the ‘load’ of sodium unnecessary.

Finally, in terms of fluid intake, urine volume is a good guide. The daily intake of liquid should be equal to the volume of urine output plus about 500ml to replenish the invisible losses, although the fluid intake should be adjusted according to the stage of the disease.

If fluid intake does not meet the patient can chew a gum or a candy or consume frozen liquids, tricks that will help him to fight the thirst.

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