Chronic renal failure is the end stage of renal disease and hemodialysis program - is one of the methods for its treatment.
If a person's diet in predialysis perioddepended on how it was kidney disease he suffered, the hemodialysis recommendations may be quite different. But the specific dietary recommendations should give the patient the attending physician. After all, they depend on the length of time hemodialysis patients, residual renal function, presence of complications, and many other reasons.
The consumption of protein, fat and carbohydrates during dialysis
The conservative period (prior to the appointment procedureDialysis), the patient usually restrict the intake of protein to 0.5 g per 1 kg of body weight per day, salt - up to 5 grams per day. In severe hypertension even prescribe completely salt-free diet, as salt in the patient an amount sufficient for the body contained in the products. Although this nebessporen mode. It might be better for a long time to sit on a low-protein, low-salt diet, but before start treatment with one type of dialysis (program hemodialysis or peritoneal dialysis).
Haemodialysis is not only permitted, but also inmost cases, it is recommended to consume more protein than healthy people. Because in the process of hemodialysis patients lose blood cleansing and beneficial substances - amino acids, oligopeptides, water-soluble vitamins, trace elements. That is why the diet for hemodialysis should be as complete, and first of all - the content of animal protein. The recommended optimal amount - 1.2 g per 1 kg of body weight per day.
Of course, the diet should be balanced: besides proteins, a sufficient amount necessary to consume fats and carbohydrates. But here it should be borne in mind, a disease leading to dialysis. If, for example, chronic renal failure caused by diabetes, the carbohydrates in the diet of the patient, of course, limited.
In patients undergoing dialysis, inevitablythere is a further decline in kidney function, including reduced and vodovydelitelnaya function - until the complete cessation of urine (anuria). Although prior to this time the presence of urine at the patient makes a significant effect on reducing the level of azotemia (excessive blood protein metabolism in nitrogen-containing products - urea, creatinine, etc.), but maintains the water balance of the body. In the course of the disease when vodovydelitelnaya renal function disappears, it is necessary to impose restrictions on fluid intake. This is especially true of patients with symptoms of heart failure and hypertension.
But it is very important individual approach, becausepreservation or extinction of vodovydelitelnoy renal function is dependent on the underlying disease. For example, in congenital renal dysplasia, polycystic, pyelonephritis, it may persist for a long time. At the same time in glomerulonephritis, diabetes mellitus, it fades very quickly. Depending on this, the doctor will establish different water regimes. The general recommendation is to use the interval between one session of hemodialysis to another such quantity of water to the liquid set was no more than 5% of body weight.
This recommendation is to eat normally in no way runs counter to the fluid restriction (approximate water content of the product is 50-70%).
During the procedure, along with the nitrogenmetabolites and other toxic substances are removed excess fluid. When the patient is gaining it too much, problems arise due to the early development of heart failure and hemodialysis poor tolerability.
When dialysis is shown limited product,containing large amounts of potassium. The body is extremely sensitive to fluctuations in the level of potassium in the blood. Since patients impaired renal function (as potassium excreted mainly by the kidneys), developed hyperkalemia (increased potassium concentration in the blood). And this condition can sometimes be fatal. The fact is that if a patient does not eat from session to session generally any products containing potassium, blood still show an increase in its content in the blood - about 1 mmol per 1 liter per day. The physiological limit of blood potassium 3-5.5 mmol per 1 liter.
Potassium contained in large amounts in the firstall in dried fruits, fresh vegetables, fruits. To a lesser extent - in animal products. Tell as much as you can eat it, so to speak, oranges a day an individual patient may only doctor.
Correction of phosphorus and calcium
Calcium and phosphorus metabolism in patients onhemodialysis is usually broken. This state should identify the attending physician. For this study carried the phosphorus and calcium levels in the blood. Count the calcium-phosphorus product, evaluated bone density by densitometry. Correction may be assigned to specific drugs (fosfatbindery, calcium supplements, vitamin D3) with simultaneous restriction products containing a large amount of phosphorus, such as dairy products.
The role of aluminum in dialysis
Limiting drugs and foods containingAluminum is important in the selection of diet in patients undergoing dialysis. Aluminium is extremely toxic to the patient with renal failure, it causes a number of serious complications - aluminum dementia (severe damage to the nervous system), bone loss, anemia. Not by chance the special water purification systems are used in hemodialysis departments, aimed, inter alia, on the disposal of aluminum. But often, for the treatment of concomitant diseases prescribers containing aluminum. Say almagel, Aluminium phosphate gel - gastritis, peptic ulcer disease. This is causing serious harm to "kidney" patients.
Patients should not also prepare food in aluminum cookware and without consultation of nephrologist doctor taking multivitamin complexes containing vitamin A and minerals.
In conclusion, we emphasize once again - at a hemodialysis diet should be balanced, full and, in the absence of complications were not significantly different from the power of a healthy person.