Dietary Advice for Patients with Kidney Failure Caused by Diabetes

Protein: As rice and flour contain a large amount of vegetable protein, while in the wheat flour, the content of vegetable protein is little.

Amino acid: the patients should take as much of necessary amino acid as possible.

Energy: when the patients are on low-protein diet, they should have sufficient intake of energy to meet the physiological needs. Some foods with low content of protein but high energy are recommended, like potato, sweet potato, Chinese yam, pumpkin.

Fat: patients with ESRD tends to develop comorbidity such as metabolic disorder of lipid, so they should stick to low-fat diet. Olive oil and peanut oil, which are rich in monounsaturated fatty acids, are recommended.

Salt intake: when ESRD develops to a certain degree, patients can develop high blood pressure, presenting edema or reduced amount of urine. Limiting the intake of salt can prevent against the progression of the complications. However, when the patients are also having vomit and diarrhea, salt intake should not be limited excessively.

Water: water is crucial for patients. When patients have oliguria even anuria, it is vital to control the intake of water. Intake of too much water would add burden to kidneys, deteriorating the kidney conditions.

Potassium: If the daily urine output is more than 1,000ml, and the serum potassium is normal, it would not be necessary to control the intake of potassium, and patients can choose vegetables and fruits freely in most cases. But if the patients have hyperkalemia, which would damage the organs even pose risks to life, they should limit the intake of foods containing too much potassium. Foods like pumpkin, apple, pear, pineapple, watermelon are recommended, as they have relatively low content of potassium.

Yet when patients present hypokalemia, they should eat more of foods rich in potassium, like spinach, kelp, banana, peach and tomato.

Calcium and phosphorous: when the kidneys are damaged, the excretion of phosphorous would lessen, leading to increasing serum phosphorous. Also the absorption of calcium is also affected by the composition of vitamin D3, which is a kidney function. When the serum calcium concentration lowers, osteoporosis is likely to happen, so the ideal diet should be able to help raise calcium and lower phosphorous.

However, when the patients have already started renal replacement treatment, they should start high-protein diet, so that they can have sufficient nutritious supply.

All of the advice should be regarded as reference, the specific dietary regimen should be made with the help of doctors, nutritionists and other medical staff.

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