Useful tips for patients on hemodialysis.
A patient receiving hemodialysis treatment should also exclude salt from use and that is why. In the absence or small amount of urine, an excess of sodium is not excreted from the body, but goes into the tissue, leading to edema, including vital organs. So, pulmonary edema can be fatal. The amount of blood flowing through the vessels also increases, which leads to an additional burden on the heart, the "pumping" function of which is already weakened by long-term hypertension. By the mechanism described above, blood pressure rises. A dialysis patient who uses salt drinks a lot of fluids and comes to the next dialysis session with a significant increase in weight. Removing such an amount of fluid during a hemodialysis session leads to a sharp drop in pressure and may not always end harmlessly. The most common mistake is to feed the dialysis patient black caviar (by selling the last shirt) "to raise hemoglobin." This is both useless and, as you now understand, unsafe.
Never eat food "from the wrong hands", i.e. food prepared by someone, whether it's a catering company, a pastry factory, or your old school friend. You must be sure that no salt was used in its preparation. Even your own wife must be trusted, but checked.
The salt shaker should be on the table, and not near the stove - let other family members salt the food already in the plate, but you better get yourself a separate salt shaker, measure 2 g of salt in it in the morning and put several grains in each dish during the day. And not a crystal anymore - this is your limit. By the way, with this use, the salt tastes much stronger.
So that the food does not seem fresh, use any seasoning: pepper, onion, garlic, herbs, horseradish, mustard, lemon juice, tomatoes. You can’t use mayonnaise, salad sauces, ketchup, soy sauce as seasonings - they all contain a lot of salt.
If you are used to having a sandwich for breakfast, use unsalted butter or low-fat cottage cheese for cooking, put a slice of tomato or cucumber on top, a salad leaf and half a cool egg are also suitable. You can make a sandwich with a toasted slice of zucchini or eggplant with garlic. Never eat canned goods, sausages, sausages, sausages, cheese, pate, ready-made salads from "cooking", guided by the principle specified in the first paragraph.
Significantly limit the use of soups and broths (vegetarian soups can be left).
Meat, fish only use boiled 3 times a week.
Exclude potassium containing foods: raisins, apricots, dried apricots, apricots, cherries, plums, oranges, tangerines, bananas, fried or baked potatoes.
Exclude the use of cheese, especially processed.
Eliminate canned meat and fish products.
If you work, try to organize a salt-free "lunch" at work. Let it include, for example, instant oatmeal porridge with fruit additives, but in no case be soup from a bag and not become popular noodles in a glass. You can also eat fruits, vegetables, bread with a low salt content (special salt-free or bran), meat or fish, boiled or fried without salt, as well as yogurt and cottage cheese.
Do not forget that mineral water, which is often advised even for doctors with kidney diseases, and soda, which is sometimes used for heartburn, are also a source of huge amounts of sodium.
If you do not know if this dish contains salt, read the label (if it is an imported product, its composition must be indicated there). At the slightest doubt, it is better not to eat this food at all.
Recommended products from soybean, cottage cheese, sour cream, milk, eggs, vegetable oil, cereals, peas, beans, boiled liver, crab sticks, boiled sausage.
The amount of fluid consumed (all) per day should not exceed more than 500 ml of the volume of urine excreted per day.
Of the products - sources of carbohydrates - rye bread, bran bread, buckwheat, oatmeal and pearl barley require caution. Excessive consumption may complicate the correction of hyperphosphatemia. Of cereals, rice is the safest. White wheat bread is one of the most balanced foods. We, the Russians, cannot do without brown bread, but its consumption often causes flatulence even without a lack of digestive enzymes.
It is better for a dialysis patient not to consume any canned food. We are not always sure that safe preservatives are used in canned food, and the harm of metal oxides from canned tin is well known. For the same reasons, one should not consume not only canned meat and fish, but also canned juices and soft drinks. Unfortunately, the use of sausages, sausages and similar products should be avoided only because at present their falsification has spread enormously and no one knows what they are made of.
Vegetables, fruits, berries, fruits.
This food is mainly a source of potassium and water. Their limitation makes sense if the patient has a potassium level above 5.5 mmol / l before hemodialysis.
Fruits and berries do not have any particularly valuable vitamin value, but they diversify food tastefully, help increase appetite, stimulate the release of digestive juices and intestinal motility.
A well-dialyzed patient does not suffer from a lack of appetite. Therefore, the "dry" weight may increase in the following cases:
a patient with uremia in the stage of decompensation, who started hemodialysis and has appetite, stopped vomiting, the dietary restrictions of the pre-dialysis period were canceled, if the dialysis patient underwent a serious surgical operation, and he naturally lost weight after it, but he gained on normal dialysis " dry "weight, close to preoperative, when switching from inadequate dialysis to adequate, because good hemodialysis is not herbalife, it does not lose weight.
Weight stability indicates a good quality of hemodialysis. A rapid decrease in dry weight means that hemodialysis is insufficient or the patient has an intercurrent disease that needs to be dealt with.
So, in dietary recommendations to hemodialysis patients, attention should first be paid to:
Let us dwell only on iron. Not a single product is a complete source of iron when it is deficient in a dialysis patient. Iron deficiency can only be compensated for with drugs, preferably orally and under the control of serum iron, transferrin and ferritin levels. It is especially important to compensate for iron deficiency during eprex treatment, when there is intensive utilization of iron for the synthesis of hemoglobin.
Squirrels. The diet of patients on hemodialysis should be high protein. Failure to comply with this rule can lead to a decrease in muscle mass, exhaustion, dystrophic changes. You should consume 1-1.2 g of protein per kg of recommended body weight per day. It is important to note that 75% of the protein should be animal protein, as It is more complete in terms of amino acid composition (low-fat beef, chicken, turkey, rabbit, tongue). The best way to cook is boiling, because 30% of the phosphorus during boiling goes into the broth. Other sources of animal protein (fish, dairy products, eggs) are recommended depending on the indicators of phosphorus: with normal indicators of phosphorus, the fish in your diet should be 1 time per week, one dairy product per day, 4 eggs with yolk per week. With an increase in phosphorus, the amount of phosphorus-containing products is limited, and phosphorus-binding drugs are prescribed. Plant protein should make up 25% of the total protein. Powerful sources of vegetable protein, such as legumes, mushrooms, nuts, seeds, are excluded, because contain a lot of potassium and phosphorus. Moderate sources of vegetable protein (baked goods and cereals) are limited. About 150 g of bread is recommended per day. Of cereals preference
given to rice cereal. If necessary, the attending physician prescribes preparations of essential amino acids.
Calorie content. The energy requirement of patients receiving dialysis treatment is high. Usually it is 30-35 kcal per kg of patient weight per day and depends on physical activity. The higher the physical activity, the higher the energy requirement. A significant part of the energy requirement should be covered by fats and carbohydrates. To increase the energy value of food, it is allowed to fry boiled foods. To cause the patient’s appetite, it is recommended not only spicy herbs, but also in a limited amount of cranberry, lemon, orange, currant, lingonberry drinks, dry wine, cahors, cognac are not forbidden in small doses.
Fats. The amount of fat in the diet should be optimal. It is allowed butter (20g per day), sour cream, vegetable oils 2 tablespoons per day (sunflower, olive, cottonseed, etc.). Vegetable oils not only taste good, but also contribute to the normalization of cholesterol metabolism.
ROLE OF FATS IN FOOD
Fats are an essential part of a complete diet.
They are an important source of energy, ensure the normal course of metabolic processes, promote the absorption of proteins and fat-soluble vitamins (A, D, E, K), improve the taste of food.
An adult should receive 1.5 g of fat per 1 kg of body weight per day.
With age, the need for fats decreases. Excessive consumption of animal fats worsens appetite, contributes to an exacerbation of liver, urinary tract diseases, a change in the blood, disruption of other processes in the body, and the development of atherosclerosis.
70% of the daily need for fats should be animal fats and 30% vegetable.
Vegetable oil improves metabolic processes in the body, has a specific effect on blood vessels, choleretic and laxative effects.
Carbohydrates. The amount of carbohydrates in the diet of patients on hemodialysis should be optimal. Patients with a lack of body weight are allowed to increase the calorie content of their diet due to carbohydrates (sweet foods - sugar, honey, jam, marshmallows, pastille, jelly, mousses, etc.). Dishes and side dishes made from cereals and pasta are limited. Used in the form of pilaf with fruits, casseroles. Patients with diabetes should monitor their carbohydrate intake under the guise of sugar-lowering drugs (insulin) under the supervision of a physician.
Phosphorus. An increase in blood levels of phosphorus over a period of time can lead to a violation of phosphorus-calcium metabolism, and disease of bones and parathyroid glands. One way to prevent these complications is to limit foods that are high in phosphorus:
Cheeses, curd masses, condensed milk with sugar and without sugar, milk, yoghurts, etc.
Useful tips for patients on hemodialysis