4 Dietary Keys for Kidney Patients to Avoid Premature Dialysis Treatment

Modifying protein intake, calorie content, water, and salt are key treatment strategies for those with renal complications.
4 Dietary Keys for Kidney Patients to Avoid Premature Dialysis Treatment
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Kuo-Pin Wu
Health Viewpoints

Ancient Chinese words of wisdom state, "30 percent by curing, 70 percent by nourishing," from which we see a clear emphasis on dietary regulation (nourishing) over medicine (curing) as the best means to treat diseases. Proper dietary monitoring can accelerate the body's recovery from illness, while an improper diet can injure the body, making it vulnerable to illness, or cause relapse of past diseases.

In traditional Chinese medicine, dietary therapy is the fundamental and most effective way to treat chronic renal failure. Dietary therapy aims to reduce the burden on the kidneys and delay their decline in functionality. Even in the later stage of renal failure, effective use of dietary therapy may delay dialysis treatment.

How to Regulate Diet for Patients With Kidney Complications

Common problems encountered by kidney patients are the imbalance of water, potassium, sodium, calcium, and other electrolytes in the body, as well as the metabolic disorders of protein, fat, and sugar, which are especially serious for patients with chronic renal failure. Therefore, correcting these imbalances and disorders is the most basic strategy for treatment, among which the control of protein, calorie content, water, and salt is the most critical. On the premise of adequate calorie supplementation, the diet should be tailored according to the patient's renal pathology and renal function.

For example, those with proteinuria or hematuria but normal kidney function can eat normally or just reduce the amount of protein and salt intake. People with edema and high blood pressure should strictly limit their water and salt intake, with salt controlled to 2 to 3 grams per day. Patients with heart failure or severe hypertension may need to reduce salt intake further, or even adopt a salt-free diet.

The specific undertakings are as follows:

1. Calorie

The amount of calorie (energy) intake will directly affect muscle protein synthesis. Therefore, patients on a long-term, low-protein diet must consume sufficient calories every day. Patients with chronic renal failure should consume 30 to 40 calories per kilogram of body weight every day, mainly from carbohydrates. They can choose potatoes, sweet potatoes, vermicelli, lotus root powder, yam, taro, glass noodles, and pumpkin. These foods are perfect fits as they all possess properties of low protein content and high calories.

2. Protein

Modern medicine believes neither too little nor too much protein intake is good for the kidneys. Studies have shown that patients with early-stage renal deficiency can remain in a relatively stable condition by consuming 1.1 ounces to 2.5 ounces (30 to 70 grams) of protein per day and only require dialysis treatment 7.6 years later on average, and patients who do not limit protein intake require dialysis after an average of just 16 months.

Timing Control

Patients with chronic renal failure must start taking a low-protein diet during the initial stage of renal dysfunction. However, many people find such a diet difficult to follow, cannot keep it continuously, and are also prone to malnutrition. Patients with normal renal function but suffering from glomerular disease should also start controlling protein intake during the development phase of the disease.

Amount of Intake

Too little protein intake can lead to malnutrition, weight loss, and decreased resistance to diseases. Different diseases and degrees of renal dysfunction require different protein restriction regimes. For patients with chronic renal failure, the daily protein intake should be limited to 0.02 to 0.03 ounces (0.5 to 0.75 grams) per kilogram of body weight.

Select High-Quality Protein

When taking protein, you should choose high-quality types, that is, food with a high content of essential amino acids. In simple terms, that means animal protein. For that purpose, it is recommended to eat egg whites, milk, fish, and lean meat. In addition, the proportion of plant protein intake should also be restricted. Conversely, foods with high plant protein content, such as beans, soy products, and nuts, must be strictly limited. The high-quality protein foods should be evenly distributed among the three meals, as opposed to taking them all in just one meal, to raise the absorption efficiency.

Those Who Should Avoid Low-Protein Diets

Patients with end-stage renal failure with obvious gastrointestinal symptoms, pericarditis, or peripheral neuropathy should not adopt a low-protein diet. Patients with poor nutritional status, who are too old, or who have chronic consumptive diseases or infections (such as tuberculosis) should not eat a low-protein diet. It should also not be used in patients with severe proteinuria or with severe water and sodium retention symptoms.

3. Table salt

Salt intake should be suitably adjusted according to the patient's condition and renal function status. Not all patients with chronic renal dysfunction need to strictly limit salt intake. In general, the salt intake of patients with chronic renal failure should be less than 5 grams per day.

4. Water

The basis for calculating daily water intake is to "take in according to outflow," that is, add 400 to 500 ml (13.5 to 17 fluid ounces) to the urine output of the previous day. The 400 to 500 ml here is a rough estimate of the moisture loss through the skin and respiratory tract.
Kuo-pin Wu is the superintendent of Taiwan Xinyitang Heart Clinic. In 2008, he started to study traditional Chinese medicine and obtained a bachelor’s degree from China Medical University in Taiwan.
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