Diabetic nephropathy “eating plan”!
Posted on November 22, 2009
Filed Under Nephropathy | Leave a Comment
Ms. Huang, 63, weight 60 kg, suffering from diabetes and renal insufficiency. Due to loss of appetite, nausea, leg edema and other symptoms increased hospitalization. After testing his urine protein +, blood urea nitrogen 16mmol / L, creatinine 260umol / L. Hospitalization over one month, using sodium bicarbonate, uremic-ching, love Sid, furosemide, effect is not obvious. Ms. Huang was wondering why the illness has been no better then? Is there a better way to alleviate the symptoms of it?
A diet therapy prescription solving difficult problems
Physician invited the physicians nutrition consultation. Dietitians in the detailed advice to her removal to illness after a dietary treatment out a prescription program to high-calorie, low-protein, low-salt diet therapy. Total thermal card at the standard weight (kg) × 30 kcal = 1800 kcal computing, in which food protein 36 grams, calories 144; staple food (rice or wheat flour) 250 grams, calories 1000; vegetables and 500 grams, calories 100; 50 grams of vegetable oil per day, calories 450, total calories 1694 kcal. Recipe arrangement: one egg per day, a bag 250 ml of milk (or meat, fish, 50 grams), 150 grams of rice or flour, wheat starch, 100 grams.
In strict accordance with the provisions of recipes treatment for 3 weeks, blood urea nitrogen by 16mmol / L dropped to 12mmol / L, creatinine by the 260umol / L dropped to 156umol / L, edema, increased appetite, nausea, symptoms improved, you can eat normally.
Dietary treatment of renal dysfunction can not be ignored
Diabetic chronic kidney disease, according to the degree of renal dysfunction can be divided into four phases: a period of compensatory renal insufficiency, serum creatinine in the 133 ~ 177umol / L, may be no symptoms; 2 of azotemia period to digest tract symptoms, mainly serum creatinine is generally 186 ~ 442umol / L. At this point, such as diet and medication properly, can reduce symptoms, slow disease progression; 3 for the period of renal failure; 4 of uremia, drug therapy has been very difficult to work, need to use dialysis and renal transplantation. At different stages of the evolution of renal failure, dietary therapy is not overlooked, Ms. Huang’s case is a good proof of this.
Diet therapy should pay attention to five “changes”
1 / Normal drinking water, drinking water to the limited changes: renal insufficiency often have varying degrees of edema, placed restrictions on the amount of water is necessary, and even more so when severe swelling. The daily water intake = urine + non-dominant loss of water (sweat, breath, stool moisture in the summer by 700 to 800 milliliters calculated by 500 to 600 milliliters in winter terms).
2 / random salt to the low-salt diet change: too much salt will increase the amount of edema or hypertension, right kidney to restore adverse kidney disease should be controlled within 4 ~ 5 g / day.
3 / high protein diet to low-protein diet changes: Diabetic nephropathy who did not diet requirements are low sugar, low-fat, high-protein diet, a daily protein intake per kg of standard body weight 0.8 to 1.0 grams. Nephropathy who requires low-protein diet, a daily protein intake per kg of standard body weight of 0.4 to 0.6 grams of protein metabolism in order to reduce generated when excess urea nitrogen and creatinine.
4 / grain protein to animal protein changes: in patients with diabetic nephropathy should eat “low and high quality” high-quality protein (animal), eating of non-high-quality protein (cereals). High-quality protein, dietary protein should account for more than 50%, grain protein, accounting for 10%. Of course, talking about eating high quality protein is not an unlimited number of eating, the total intake must be controlled better.
5 / corn starch, wheat starch to change: maize, rice, raw flour protein content of about 8% to 10%, while after processing of wheat starch, protein content of only 0.6% ~ 0.8%, so not only can ensure the wheat the supply of starch calories, but also can control the grain protein intake. Wheat starch-containing protein, at least, resulting in the least amount of urea nitrogen and creatinine.
Of course, in the diet therapy must also attach importance to drug therapy, primarily to reduce blood acidity, improve gastrointestinal symptoms; added the essential amino acids; promotion of non-protein nitrogen discharges, inhibit synthesis of non-protein nitrogen; symptomatic treatment.
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