The main principles in the diet of patients on hemodialysis are:
- Fluid restriction.
- Limiting salt intake.
- Limit the intake of foods rich in potassium.
- Limit foods that are rich in phosphorus.
- Adequate protein intake.
- Sufficient energy.
With the start of dialysis treatment the amount of urine asgenerally decreases. Do not drink more than the daily urine output plus 500 ml. Weight gain should not exceed 2 kg per interdialytic period. Otherwise, fluid builds up in the body and can lead to serious complications such as pulmonary edema, cerebral edema. Do not forget to count and the fluid that is found in vegetables, fruits, first courses, sauces, gravies, dairy dishes, and so on. D. To quench your thirst you will slice of lemon or a piece of ice.
Zoom thirst will also significantlylimit salt in your diet. Instead of salt to improve the taste of food can add pepper, herbs, mustard, bay leaf, cinnamon, vanilla. To improve the palatability of salt-free foods in the diet is introduced sweet and sour sauce, sour cream, vegetable and fruit sauce, citric acid. To replace salt in boiled fish can add the cloves, allspice; in a stew - basil; potatoes in onion, garlic; at any spicy dish - pepper, parsley. Excluded from the diet of pickles, sausage and other foods that contain a lot of salt. The food is prepared without salt and lightly prisalivaem already ready meals (3/4 teaspoon without a top, no more salt per day).
Own the kidneys in patients with chronicrenal failure is almost recovered potassium. Significant accumulation of potassium in interdialytic period can be very dangerous for your life! The only way to prevent hyperkalemia is severe restriction in your diet foods rich in potassium.
The following foods contain large amounts of potassium and should be avoided:
- Dairy products (cguschennoe milk, evaporated milk);
- Vegetables (bean products, mushrooms, spinach, jacket potatoes, roast potatoes, chips);
- Fruits (apricots, bananas, dried fruit, nuts, rhubarb);
- Grain products (bran, fruit and chocolate cakes, chocolate biscuits, crisp bread, corn flakes);
- Drinks (coffee, beer, wine, cocoa, drinks from cocoa);
- Mixed (salt substitutes, chocolate, toffee, fruit gum, peanut butter, tomato puree, vegetable soups).
Comments: Major sources of potassium are vegetables andfruit. Therefore, you should limit the amount of fresh fruit and a number of salads. To reduce the content of potassium in vegetables should be peeled, cut into small pieces and soak for 6 - 10 hours Vegetables should be cooked in plenty of water, pour the broth. It is not recommended to cook steamed vegetables, use a pressure cooker, microwave oven, grill them. Canned fruits contain less potassium than fresh, but the syrup should be discarded. Rice and pasta contain less potassium than potatoes, therefore their use is preferable.
The increase in blood phosphorus indicators for a certain time may impair the calcium metabolism, bone disease and parathyroid glands.
One way to prevent these complications is the limitation of high-phosphorus product:
- Dairy products (cheeses, syrkovoy mass, sweetened condensed milk and sugar, milk, yogurt, etc...);
- By-products (liver, kidney, heart, etc...);
- Fish (smoked fish, mackerel, sardines, trout, salmon roe caviar chum salmon, sturgeon caviar);
- egg yolks;
- Mushrooms, nuts, seeds;
- Drinks (milk and chocolate drinks);
- Grain products (bran, wheat tortillas. Chocolate cookies. Chocolate Cake).
Doctor will prescribe medication, if necessary,which helps lower blood phosphorus content (calcium supplements). It is important to remember that it should be taken just before a meal or during a meal. Otherwise it will have no effect. To limit inputs of phosphorus to be more likely to look at the nutrient content of the table, and exclude or limit foods high in phosphorus or phosphorus high-protein ratio (more than 20). Phospho-protein ratio - the ratio of the amount of phosphorus in the product to the content in mg of protein
The diet of patients on hemodialysis, shouldbe vysokobelkovoj. Failure to do so may result in decreased muscle mass depletion, dystrophic changes. You must use 1 - 1.2 g of protein per kg body weight of the recommended daily. It is important to note that preference is given to proteins, a complete amino acid composition, basically, it is animal protein (lean beef varieties, chicken, turkey, rabbit, tongue boiled).
However, many high-grade protein mealscontain large amounts of phosphorus, so their use must be controlled (fish, dairy products, eggs). It allowed varieties of fish, in which the phosphorus content is low: grenadier, haddock, cod, sturgeon. The milk must be limited to 1 st cups a day cream is allowed to 150 g per day. Eggs - 4 units per week in the form of protein omelet, runny and for cooking other dishes. Meat and fish are boiled or followed by roasting, thereby reducing the amount of extractives.
The amount of fat in the diet should be optimal. Allowed butter (20g per day), and vegetable oils (sunflower, olive, cottonseed, etc.). These oils not only taste good, but also contribute to normalization of cholesterol exchange. Refractory fats are eliminated.
The amount of carbohydrate in the diet of patientson hemodialysis should be optimal. Patients with a body mass deficit is allowed to increase the caloric content of their diet from carbohydrates (sweet food - sugar, honey, jam, jelly, mousse, etc.). Dishes and garnishes from groats and pasta are limited. Use in the form of fruit pilaf, casseroles, as a side dish. Patients with diabetes should control the intake of carbohydrates undercover antidiabetic drugs (insulin) under the supervision of a physician.
The energy requirement in patients receivingdialysis is high. Usually, it is 35 kcal per kg body weight of the patient and is dependent upon physical activity. The higher physical activity, the higher energy requirement. A significant part of the energy needs should be covered by fat and carbohydrates. To increase the energy value of food is allowed to fry foods cooked in boiled form. To access the appetite of the patient is recommended not only spicy greens, and a limited number cranberry, lemon, orange, currant, cranberry drinks are not forbidden in small doses, dry wine, Cahors, brandy. Patients with overweight and increased rates of blood lipids, to reduce fat intake should: limit the amount of animal fat, do not fry food; Avoid pastries, eat foods low in fat and sugar.
So, dear patients! Our advice on nutrition aimed at improving the quality of your life! By performing them, you can avoid possible complications.