What dietary taboos should be noted for nephritis?

The core dietary taboos for patients with nephritis are actually uncontrolled high-salt, excessive high-protein, high-purine intake, as well as blindly taking kidney-tonifying health products with unknown ingredients. The most widely spread "no soy products at all" is actually a cognitive misunderstanding. There are still different opinions on this in the academic community.

I met a 30-year-old patient with chronic nephritis a while ago. His urinary protein was basically within the standard of 0.3g. He took annual leave to go to the beach for a week, ate pickled seafood and iced beer, and had sex with friends at night. When he came back for a review, his urine protein was 2+, and his creatinine was 28 μmol/L higher than before. He had definitely stepped on the triple trap of high salt, high purine, and excessive protein.

Many people's understanding of salt control is still "put less salt in cooking". In fact, invisible salt is something that is hard to guard against. I met a retired aunt before, and her cooking was so bland that it was almost salty, and she often suffered from edema. Later, I looked through her food diary and found out that she ate two pieces of whole-wheat bread called "healthy and additive-free" every morning. The sodium content of that bread was 320 mg per 100 grams, which is almost 1 g of salt. Add in the sodium in the sauces she occasionally eats such as prunes and noodles, and her daily salt intake has already exceeded the upper limit of 3 g required by nephritis patients.

Let’s talk about the issue of soy products that everyone is most concerned about. In the early years, many clinicians would indeed recommend that patients with nephritis completely avoid soy products. This was mainly because they believed that plant protein metabolism wastes a lot and would increase the burden on the kidneys. However, evidence-based research in the past few years has confirmed that the amino acid ratio of high-quality protein in soybeans is almost the same as that of animal protein. As long as the total daily protein intake is controlled, it can be eaten in small amounts. There was a patient who heard the old saying that he didn't even dare to touch tofu. After half a year, his albumin dropped to 32g/L, and he felt so soft that he caught colds all the time. On the contrary, every cold caused an increase in urinary protein. Later, he adjusted his diet and added half a piece of northern tofu every day. His nutrition kept up with him, and his indicators became much more stable. Of course, some doctors are still cautious now, mainly because they are afraid that many patients will not be able to control the amount, and eating a whole plate of tofu in one meal will exceed the standard. If your kidney function has been significantly damaged, just listen to the advice of your attending doctor, and do not have to worry about what is said on the Internet.

There are also many people who think that nephritis means "kidney deficiency" and they need to be replenished. They secretly buy various health products and ancestral secret recipes that claim to "nourishe the kidney", or drink Laohuo soup made with ginseng and astragalus. This is also a taboo. Let’s not talk about whether the supplement is correct or not. Many unknown health products contain unknown ingredients, which will increase the metabolic burden on the kidneys. Last year, I met a young man who took the “kidney-tonifying pills” recommended by a friend for three months. It was originally just a mild latent nephritis, but he suffered acute kidney injury. He was hospitalized for a week before he recovered. If you really want to take supplements, be sure to ask your doctor first and don’t take them blindly.

In fact, the diet for nephritis is not as strict as everyone thinks. You don’t have to boil water every day until you feel hungry. You just need to dynamically adjust according to your own indicators. For example, if there is no edema and normal urine output, there is no need to deliberately restrict water. If the urine protein is stable, eating eggs and drinking milk normally will be fine. Excessive dietary restrictions will destroy the body, and the gain will not be worth the candle.