Chronic kidney disease (chronic renal failure / end stage renal disease) and its dietary management

End stage renal disease (ESRD) occurs when chronic kidney disease worsens kidney function to less than 10% of normal value. The kidneys do not function at the level required for daily living. The main function of the kidney is accumulation in kidney failure to eliminate the body waste and excessive moisture and lead to toxicity. Treatment includes kidney transplantation or dialysis by dietary management.

ESRD always follows chronic kidney disease. The most common cause is diabetes and hypertension. Other causes are -

1. Diseases affecting arteries reaching the kidneys or exiting the kidneys.

2. Congenital kidney abnormality

3. Polycystic kidney

4. Too much abuse of analgesics and other medicines

5. Toxic chemicals

6. Systemic lupus erythematosus (SLE), scleroderma

7. Injury

8. Glomerulonephritis

9. Kidney stones and secondary infection

10. Reflux nephropathy

11. Various other renal diseases

Symptoms include:

1. General mood and fatigue

2. Itching and dry skin

3. Weight loss without effort

4. Headache

5. Anorexia

6. Nausea and vomiting

7. Swelling

8. Bone pain

9. Bad breath

10. Unusually dark skin

11. Change of nail

12. Easily bleeding - contusions, nosebleeds, blood in feces

13. Impotence

14. Restless legs syndrome

15. Insomnia

16. Excessive thirst

17. Frequent hiccups

18. Amenorrhea

19. Drowsiness and confusion

20. I can not concentrate or think clearly

21. Paralysis of different parts of the body

Muscle cramps or convulsions.

23. Abnormal health and lung sound

24. Urine production declined or not at all

ESRD results in the accumulation of body waste and body fluids that affect most body systems and functions including blood pressure management, erythropoiesis, electrolyte balance, vitamin D and calcium levels and hence bone health. Therefore, dialysis patients often need to undergo various examinations to manage the condition,

1. Sodium

potassium

Rin

4. Calcium

5. Magnesium

Albumin

7. Cholesterol

8. Electrolyte

Complete blood count (CBC)

10. Erythropoietin

11. Parathyroid hormone (PTH)

12. Bone density test

Treatment and management -

For the management and treatment of ESRD, it includes kidney transplantation, dialysis, diet therapy, etc. However, it is essential for the patient to know and understand everything about dialysis and treatment concerning dialysis.

Why dialysis - dialysis helps to eliminate and maintain body waste, body fluids, electrolyte balance. Because dialysis alone can not effectively remove all waste products, a special meal is important. Meal management also helps minimize accumulation of waste and help maintain body fluids, electrolytes and mineral balance in the body during dialysis.

One needs to make many changes in their diet -

ESRD patients need high protein, low sodium, potassium, phosphorus diet and restricted fluid intake. Let's study it in detail little by little.

Fluid-

Urine comes out during renal failure. Because most dialysis patients mostly do not urinate or do not urinate at all, liquid limitations between treatments are very important. Body fluid accumulates in the body without urination, excessive body fluid is generated in the heart, lung, and ankle.

Your nutritionist needs the amount of liquid you need every day,

• Urine emissions in 24 hours

• Weight gain during dialysis treatment

• Liquid retention

• Level of food sodium

• Are you suffering from congestive heart failure?

Hint -

• Avoid eating too much moisture like soup, jelly ow, pop ice, ice cream, grape, melon, palm fruit, coconut water, lettuce, tomato and celery.

• Use small glasses.

•Drink water

• Minimize sodium intake. Avoid salty foods

• Freezing the juice in the ice and sucking them to minimize thirst (counting the number of these ice at daily intake)

• Avoid getting excessively hot and go out under the sun.

Sodium balance -

As mentioned above, ESRD patients need to avoid high sodium diet. ESRD hypertension is mainly due to sodium balance and body fluid swelling (excess accumulation of body fluids in the body). Patients with dialysis ESRD can effectively treat or control high blood pressure without using antihypertensive agents by taking low sodium diet (2 g / day). Also, if the intake of sodium is low, you can relieve thirst and avoid excessive body fluid intake.

Hint -

• Avoid canning, processed foods, processed smoked meat.

• Avoid food with salted chips, nuts, etc.

• Read the label carefully - choose low sodium, no salt added, no sodium, no salt.

• Avoid foods with salt listed near the beginning of the foodstuff list.

• Choose food containing less than 100 mg of salt per serving.

• Remove the salt shaker from the table.

• Instead of cooking the hood without using salt, use herbs for the flavor.

• Avoid preserved foods - ketchup, sauce, pickles, poppadam

• Do not use salt. It contains potassium. Potassium is also limited to kidney disease.

Potassium balance -

Usually, high-potassium diet is recommended for controlling high blood pressure, so it minimizes the risk of stroke and heart failure, but ESRD can not excrete potassium from the body, so it can not tolerate high potassium diet. A high potassium concentration in the blood results in life-threatening hypercalcemia-induced arrhythmia.

Hint -

• Avoid bananas, musk melons, cantaloupes, kiwi, mandarin, prunes, nectarines, coconut water, tomatoes, avocados, orange juice, raisins, dried fruits.

• Have fruits such as peach, grape, pear, cherry, apple, fruit, pineapple, plum, tangerine, watermelon.

• Avoid potassium-rich vegetables, spinach, pumpkin, winter squash, sweet potato, potatoes, asparagus.

• Choose vegetables such as broccoli, cabbage, carrot, cauliflower, celery, cucumber, eggplant (eggplant / brinjal), green and wax beans, lettuce, onion, green pepper, watercress, cucumber and yellow squash.

• Avoid beans, milk and bran cereals.

• Limit potassium intake to 2 g / day.

Iron -

Additional iron is also required for ESRD patients.

Hint -

• To eat foods with high iron levels. Consume rims and kidney beans, roots, green leafy vegetables (please avoid spinach), finger millet, chicken, liver, pork.

• Eat iron-fortified cereals

• Take iron supplements with the advice of a doctor or nutritionist.

Calcium and phosphorus-

In ESRD, phosphorus concentration increases because it is not excreted from the body. Phosphorus levels may be too high even in the early stages of kidney disease. High phosphorus levels lead to itching, vascular calcification, secondary hyperparathyroidism and low calcium levels. Therefore calcium deposited in bone is used up to bring about osteoporosis. Therefore, we recommend phosphate-restricted diet.

Hint -

• Restrict consumption of milk, yogurt, cheese dairy products.

• Less phosphorus allows you to take dairy products such as margarine, butter, cream cheese, full fat cream, brie cheese, sherbet.

• Consult your nutritionist, ingest calcium and vitamin D supplements, and help control the level of calcium phosphate.

• Avoid canned processed foods.

If the level of phosphorus is not managed by the diet, the doctor may prescribe the phosphorus binder.

Weight management -

Because of the lack of ESRD patient weight for some reason, we need to monitor and manage the weight with a properly balanced diet. The average caloric intake of ESRD patients falls to less than 30-35 kcal / kg / day, leading to malnutrition. To prevent malnutrition and morbidity and mortality, ESRD patients undergoing dialysis need to undergo periodic nutritional screening and testing comparing initial body weights to normal and ideal weight, dietary reviews, and food diary assessments is there.

Protein-

If you say ESRD patients need high protein, you must be confused. Because most known facts are that kidney disease patients should limit protein intake. As urea decomposes in the body and urine can not be excreted, it will become toxic if it accumulates in the bloodstream. This limited protein diet is until the patient undergoes dialysis. Since the protein loss of the patient undergoing dialysis is higher, it is necessary to take a high protein diet. The recommended dietary protein for hemodialysis patients is 1.2 g / kg body weight / day and 1.2 - 1.3 g / kg body weight / day for peritoneal dialysis patients. If dietary calorie intake is not sufficient, the patient should take nutritional supplement under the guidance of a nutritionist and tube feed or parenteral supplement as necessary.

Hint -

• Eat high-quality protein - Eat every meal, fish, pork, eggs, kidney beans, Bengal grams, soybeans.

• Add egg white or egg white powder or protein powder to the meal.

carbohydrate -

If you are overweight and have diabetes you need to limit the intake of carbohydrates, but you need to take a high carbohydrate diet to lose weight. Carbohydrates are a good source of energy. Your doctor or dietician will recommend the amount of carbohydrate needed for your diet.

Hint -

• Fruits, vegetables, bread, grains are included due to high fiber, mineral, vitamins and energy sources.

• If you are recommended for high calorie diet, please take hard candy, sugar, honey, jelly, pie, cake, cookie.

• Avoid desserts made from dairy products, chocolate, nuts and bananas.

Fat-

Because ESRD patients undergoing dialysis are at high risk of developing coronary artery disease, it is recommended to restrict the intake of saturated fats and cholesterol. They have predominantly high triglyceride levels, high LDL (low density lipoprotein) and low HDL (high density lipoprotein). We recommend eating high calorie diet, but you should avoid triglycerides and foods that raise cholesterol levels

Hint -

• Include foods that are mono-unsaturated fat and highly unsaturated fat and have low saturated fat. Sesame seed oil, linseed oil, olive oil, cottonseed oil and so on.

• Do not allow canola oil, coconut oil, fat, poultry, chicken, etc. to adhere to the skin.

Micronutrient-

ESRDS patients are recommended for low fat diet and restricted fluid intake. Therefore, many patients need to take vitamin supplements as fat-soluble (A, D, E and K) vitamins, water-soluble vitamins can not adequately absorb diet and water-soluble vitamins are also treated by dialysis treatment Lost inside. In most cases, these vitamins are given through the vein during dialysis treatment.

It is not an easy task to manage all of the above nutrients in the right amount that matches your needs and you can not do it yourself. Please do not diet that may endanger your health. This article is for your information and knowledge. Please consult a nutritionist who can design a diet that suits your special needs. Always take your family to understand your dietary needs so that you can help obey your meal. Following the proper diet and physical activity as recommended by a doctor, a dietician will make you feel better and will help you live a relatively healthy life at ESRD.