Nutrition for patients with chronic kidney disease before dialysis

The article is professionally consulted by Specialist Doctor I Nguyen Hung - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Diet plays a very important role in the treatment of patients with chronic kidney disease, especially those who are not on dialysis. A reasonable diet will have a positive impact on the patient's future dialysis performance.

Chronic kidney disease is caused by an abnormality in the structure or function of the kidneys that lasts for more than 3 months and has a negative impact on health. About 10-13% of the population has this disease.
Nutritional principles for people with chronic kidney disease before dialysis are as follows:
Protein: use about 0.6-0.8g/kg/day. Depending on the severity of the disease, the application of protein requirements in the diet will vary. Priority should be given to proteins with high biological value such as fish, eggs, lean meat, and milk. Reducing protein in the diet helps slow the progression of the disease to end-stage chronic kidney failure; Energy: the need for energy ranges from 35-40 kcal/kg/day; Fat: less than 30% of total energy intake; Phosphorus: 300-600 mg per day should be added; Calcium: every day should supplement from 900-1200 mg; Sodium: about 1000-2000 mg/day depending on the degree of edema and blood pressure; Iron: when the patient is on a vegetarian or reduced protein diet, iron supplements are required; Potassium: supplement about 2000-3000 mg/day; When there is increased potassium in the blood, edema or little urination, limit it to less than 1000 mg. During meals, do not drink too much broth because it contains a lot of potassium; Vitamins: should add water-soluble vitamins such as vitamin B, vitamin C, if the patient has manifestations of bone dystrophy or hyperparathyroidism, fat-soluble vitamins can be added, such as vitamin D3; Salt: Should limit salt in the processing of dishes; Water: Balance water in and out;

Some foods that patients with chronic kidney disease before dialysis should use include:
Low-protein starchy foods such as vermicelli, white rice, sweet potatoes, vermicelli, pho... Chronic kidney failure often accompanies According to diabetes, patients with this disease should choose foods with a low or only moderate glycemic index; Eat foods rich in biologically high protein. The degree and stage of kidney failure will determine the amount of protein needed. Use vegetable oils such as sesame, soybean, olive...; Patients with mild chronic kidney disease can eat a variety of vegetables and fruits. For patients with chronic kidney disease with diabetes should choose fruits with a low glycemic index; Should choose foods low in salt;

Some foods that patients with chronic kidney disease should limit before dialysis:
Potassium-rich foods such as dragon fruit, avocado, raisins...., green leafy vegetables such as morning glory, spinach...., kinds of bean;

People with chronic kidney disease and diabetes should limit foods with a high glycemic index such as potatoes, white bread...; Limit foods containing harmful fats, rich in cholesterol, saturated fats such as avocado, liver, heart,...; Foods containing a lot of phosphorus should also be limited such as egg yolks, beef, soybeans...; Limit eating foods such as dried fish, bread, chips... because they contain a lot of sodium salt; Drinking too much water can make the body more edematous, it also becomes more difficult to control blood pressure, so it is also necessary to limit drinking too much water. In addition, patients in the early stages of chronic kidney disease will urinate more, especially at night, causing insomnia.

Here are some benefits that a reasonable diet brings to patients with chronic kidney disease before dialysis:
Preserve kidney function; The time to enter dialysis is prolonged; Limit the possible complications of chronic kidney disease; Slowing the progression of the disease to end-stage chronic renal failure; Improve and enhance the quality of life for patients; Malnutrition is prevented and treated Correction of metabolic disorders In the treatment methods applied to people with chronic kidney disease, diet plays a very important role in reducing significant progression of renal failure. Therefore, to contribute to improving the effectiveness of dialysis, patients should build themselves a reasonable diet.
Dr. Nguyen Hung graduated as a doctor specializing in General Internal Medicine - University of Medicine and Pharmacy, Ho Chi Minh City; Can speak English and French. With over 36 years of experience in the profession, of which 17 years is the Head of the Department of Endocrinology - Endocrinology, Da Nang Hospital, the doctor has experience in treating endocrine - diabetes and kidney diseases. Currently, he is an endocrinologist at the Department of Medical Examination & Internal Medicine at Vinmec Danang International General Hospital.