Dialysis patients, look here! Experts from Changsha Fourth Hospital tell you how to eat scientifically

Dialysis treatment often increases the loss of protein and nutrients in the body while removing toxins. Therefore, dialysis patients need to be "meticulous" about their diet, because if they are not careful in their diet, they may experience critical conditions such as itching, numbness in the hands and feet, and general weakness.

So how should these patients eat and what should they pay attention to? Experts from Changsha Fourth Hospital will teach you~

Dialysis patients should follow the principle of "three highs and four lows" (high calories, high protein, high vitamins, low salt, low potassium, low phosphorus, and low water).

Three highs:

High-calorie diet: Uremia patients lose some nutrients while removing toxins through dialysis. Sufficient calorie intake can prevent protein decomposition and improve protein utilization.

The daily calorie intake of dialysis patients should be controlled at 30-35Kcal/kg.d. The main sources of calories are carbohydrates and fats, with carbohydrates: fats = 3:1. Try to choose high-calorie foods as staple foods, such as potatoes, taro, lotus root, vermicelli, lotus root starch and other staple foods.

High-protein diet: Different from non-dialysis patients, dialysis patients need to consume 1.0-1.2g/kg.d of protein per day, mainly high-quality proteins such as eggs, milk, and meat, and reduce non-high-quality plant proteins such as grains, peanuts, and nuts. It is recommended to eat 2-3 taels of meat, an egg, and a bottle of milk per day.

High-vitamin diet: Eat appropriate amounts of fresh fruits and vegetables and have a balanced diet.

Four lows:

Low-water, low-salt diet:

Dialysis patients often have reduced urine output or even no urine output. Drinking too much water can easily lead to water and sodium retention, edema, and induce heart failure symptoms such as chest tightness and shortness of breath. The total daily water intake of dialysis patients should be = urine volume of the previous day + 500mL, but it needs to be adjusted individually based on urine volume, weight, dialysis frequency, dehydration, etc.

Weight gain during dialysis should not exceed 5% of the original body weight. In addition, a low-salt, low-sodium, light diet should be adopted, with a daily salt intake of 3-5g, and condiments with high sodium content should be avoided.

Water control tips:

Do not eat foods with high water content such as porridge and noodle soup;

Use a small cup with scales to drink water in moderation;

You can gargle with ice water to relieve dry mouth.

Low potassium diet:

Hyperkalemia is a common complication in patients with uremia. It can cause numbness of the limbs, fatigue, and arrhythmia. In severe cases, it can cause cardiac arrest and the risk of sudden death is extremely high.

Therefore, hyperkalemia is also one of the indications for emergency hemodialysis. It is particularly important to strictly limit the intake of potassium-containing foods. Dialysis patients should control their daily potassium intake to 2000 mg/d. Red and yellow foods are usually rich in potassium, such as oranges, bananas, grapefruits, pumpkins, sweet potatoes, red dates, etc. In addition, almost all dried fruits, such as dried fruits, raisins, and dried almonds are rich in potassium.

Tips for controlling potassium:

Cut the food first and then wash it, soak it in clean water for more than half an hour, and then blanch it in boiling water;

Peel and slice root vegetables such as potatoes and lettuce, and blanch them before cooking;

Avoid soaking rice in soup or drinking soup.

Low-phosphorus diet:

Hyperphosphatemia is the culprit for the unbearable itching of the skin in patients with renal failure. In addition, long-term hyperphosphatemia can also cause calcium-phosphorus metabolism disorders, leading to symptoms such as bone pain, fatigue, limb ulcers, and may also induce cardiovascular disease; the daily phosphorus intake of dialysis patients should be controlled at 600-1000 mg/d. Mushrooms, shrimps and shellfish, animal offal, smoked processed foods, and nuts are usually rich in phosphorus, and the intake should be appropriately controlled.

Tips for controlling phosphorus:

Boil the meat first, then remove the soup and eat the meat;

If it is difficult to control blood phosphorus intake through diet, or if hyperphosphatemia occurs repeatedly, you can also use medication to lower phosphorus.

The nutritional status of dialysis patients is closely related to their survival. They should be evaluated regularly and their diet adjusted in a timely manner. Under the guidance of a nephrologist, a reasonable diet plan should be developed based on individual circumstances to ensure good nutritional status and reduce the occurrence of complications.

Hunan Medical Chat Special Author: Deng Jun and Xiang Li from Changsha Fourth Hospital

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(Edited by ZS)