What are the dietary taboos for proteinuria?

The core dietary taboo for people with proteinuria is never to completely avoid eating meat, eggs, and milk. It is to avoid the two extremes of "excessive taboos/excessive high protein" and to avoid the two big pitfalls of invisible high-salt and kidney-damaging processed foods.

Among the many kidney friends I usually interact with, I met a 28-year-old programmer last week. The physical examination showed that the urine protein was 1+ and the 24-hour ration was 0.7g. I searched online and said that I should avoid protein. He only had white porridge with vegetables for three weeks in a row and did not even dare to touch egg yolks. During the review, the blood albumin dropped directly to 35g/L, and the urine protein increased to 1.2g. He was so weak that he could not even sit still while typing code. In fact, the kidneys are like a filter whose pores have become deformed after being used for a long time. It will leak protein. If you don't supplement your body with enough high-quality protein at all, you won't even have the raw materials to repair the broken parts of the filter, and the leakage will only become worse. ； On the other hand, if you make a lot of braised pork, seafood, and bone soup, it will be like putting crazy pressure on the filter. The already loose sieve holes will definitely be opened wider, and more protein will leak out. Generally speaking, people whose 24-hour urinary protein quantification exceeds 1g should control their daily protein intake to 0.8-1.0g per kilogram of body weight, which is almost equivalent to a person weighing 60kg. One egg, a cup of 200ml milk, and a piece of lean meat as big as a palm is enough every day.

After talking about the misunderstandings about protein, what many people tend to overlook is actually the issue of salt. Don’t think that adding two tablespoons less salt is enough when cooking. There are really many hidden salt pitfalls. There was a 60-year-old aunt who had been suffering from chronic nephritis for 3 years. The urine protein had been stable at about 0.5g. During that time, it suddenly increased to 1.1g. After asking for a long time, she said that her son had recently bought a lot of plums and salted melon seeds as snacks. He also drank porridge with fermented bean curd in the morning. It seemed that he did not eat much salt. The daily intake was almost 10g, which was more than three times the required amount. After controlling snacks and pickled products for half a month, it dropped back to 0.6g after a review.

Oh, by the way, there is another issue about soy products that has been controversial for many years. Many old beliefs say that proteinuria should not touch soybean milk and tofu. In fact, the clinical statement has been updated for a long time. If you only have proteinuria and your kidney function is completely normal, you can eat high-quality protein from soybeans. Drinking a cup of 200ml of soymilk every day, or eating a piece of tofu as big as your palm, is more conducive to controlling blood lipids than eating too much red meat, and it does not put a lot of burden on the kidneys.； However, if you have renal insufficiency and the glomerular filtration rate is lower than 60, many doctors will still recommend appropriately reducing the proportion of plant protein and eating more high-quality animal protein such as eggs, milk, and lean meat. Different people have different situations, so don’t directly copy other people’s taboo lists.

Another taboo that is rarely mentioned is that you should not take supplements with so-called kidney-protecting foods, such as eating pork loin to supplement waist and cordyceps to supplement protein. I have seen several people who take supplements randomly. Either eating pork loin will cause the uric acid to spike, or taking Internet celebrity kidney-protecting health products with unknown ingredients will double the urinary protein. If you really want to adjust your diet, you should first consult a nephrologist or nutritionist to calculate your daily protein and salt intake. It is much more reliable than blindly checking posts on your own to make random dietary choices.