1. Guarantee calorie needs: This is the premise of the diet therapy because inadequate intake of calories can cause a decrease in protein synthesis and degradation of muscle proteins increases. The average calorie intake per day should 125.5-146.4kl / kg nitrogen (g) .Calorie (Coke) Ratio of consumption must 1: 250-400, calorie intake of carbohydrates should account for about 70%, consumption input fats should avoid foods high in cholesterol, unsaturated fatty acids: Saturated with grasa≥1-2. For patients with reduced food intake may be appropriate to increase vegetable oil, non-diabetic patients may increase sugar intake to meet calorie needs.
2. High protein diet: They benefit from lower blood uremic nitrogen, reduce symptoms of chronic renal failure, and can reduce high glomerular filtration and tubular high metabolic rather slow process of deterioration of renal function. Besides limiting protein intake, while also limiting the intake of phosphorus, helps reduce the extent of disease secondary hyperparathyroidism. The amount of protein restriction differ according to renal function.
(1) Application low-protein diet must meet the following conditions: ① quality while reducing nitrogen intake, we must be able to maintain nitrogen balance. ② diet intake has enough essential amino acids, including proteins of high biological value, must represent more than 65% -75%. ③ contains enough calories. ④ When not ensure an adequate intake of calories, or severe proteinuria, you should not use LPD.
(2) Application of low protein diet should pay attention to the following: ① Application LPD must be in the beginning decompensated chronic renal failure. ② search should not be one-sided lowering of BUN in blood. Patients with chronic renal failure, low BUN and Scr levels may indicate a poor prognosis and increased mortality. ③ should see the adverse effects of low protein diet in predialysis patients, some scholars have observed a low protein diet before dialysis, can aggravate malnutrition dialysis, increased susceptibility to infection. ④ In patients with chronic renal failure, loss of appetite and kidney dysfunction in proportion to its extent, inadequate diet low in protein, most malnourished. ⑤ high protein diet to avoid yolks high phosphorus inedible egg, meat, fish etc should be boiled after abandoned water consumption. ⑥ low protein diet in patients with poor compliance.
3. Low-protein diet plus starch: starch, wheat flour after removal of protein products of protein per 100 g wheat starch 0.25 only one 0.6g, that 2.6% rice flour 9.9% is much lower but provide heat 1464.4kJ. In addition, potato, sweet potato, arrowroot flour, noodles and other foods are low in protein, but with a minimum protein content of wheat starch due to bad taste, it is necessary to adjust in the kitchen.
4. Low protein essential amino acid (EAA) and renal dry syrup: Chronic renal failure in patients with disorders of amino acid metabolism in vivo, demonstrations is that the level of EAA fell, often non-essential amino excess. Because protein diet containing EAA impossible> 50%, of the need to add EAA.Se applies to: ① No significant complications in patients with CRF. ② Patients on hemodialysis low frequency. ③ hemodialysis with malnutrition.
5. Low Protein Plus α a keto acid (KAA) and kidney Spirit: α a keto acid is a precursor amino acid can be converted in the body into amino acids, which can help improve patients with chronic renal failure and malnutrition itself ketoacid not contain nitrogen, does not cause an increase in body nitrogen metabolites. Y: ① To PTH has some inhibitory effect, help treat renal osteodystrophy. ② You can restore some of the surface of the red blood cell enzyme activity uremia beneficial to extend the life of red blood cells. ③ uremic patients may improve acidosis.
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