What are the dietary taboos for uremia?

To put it bluntly, the core dietary taboos for patients with uremia are not to put extra burden on the already disabled kidneys (or the metabolic system that relies on dialysis). The intake of high-potassium, high-phosphorus, and heavy-salt foods must be controlled. The intake of water and protein must follow the patient's condition. It is not at all the extreme state of "you can't eat this and you can't eat that" posted on the Internet.

Last week, I met 37-year-old Chen during a follow-up visit in the dialysis room. His indicators have been stable for 3 years of regular dialysis. The day before, he had a treat at home. He ate half a plate of cold spinach, two braised duck wings, and half a catty of Millennium Fruit. In the middle of the night, he felt... His lips were numb and his heart was pounding. When he called 120, his blood potassium spiked to 7.3mmol/L, and he was immediately intubated for emergency dialysis. He patted his thigh afterwards and said that he had known that he would suffer such a big deal if he was greedy for such a thing, so he would not eat anything at all.

Some people will definitely think this is too exaggerated. Will high-potassium fruits and vegetables have to be completely blackened in the future? Really not. There are actually different clinical trends regarding the dietary intake of uremic patients: For patients who have not yet started regular dialysis, doctors usually recommend strict restriction of protein, potassium, and phosphorus intake to try to slow down the deterioration of kidney function. ； However, patients who have maintained regular dialysis 2-3 times a week and met the dialysis adequacy standard do not need to restrict their diet too much. As long as they control the total intake, it is perfectly fine to occasionally eat an orange slice or two mouthfuls of cold vegetables. If they really dare not eat anything, they will suffer from hypoalbuminemia and malnutrition, which is much more harmful than eating high-potassium foods occasionally.

The pitfall that many patients easily fall into is actually "invisible harmful ingredients". Take high phosphorus as an example. Everyone knows that animal offal and shelled seafood are high in phosphorus, but they often ignore the phosphate additives in processed foods, phosphoric acid in cola, sparkling water, potato chips, prepared dishes, added The absorption rate of modified phosphates in artificial meat products is much higher than that of phosphorus in natural foods. Many patients always feel itchy skin and joint pain for no reason. After checking, they found out that they secretly drank ice cola every day, and the excess phosphorus could not be excreted and accumulated in the soft tissues. There is also the pitfall of heavy salt. Everyone pays attention to the apparently high-salt foods such as pickled vegetables, soy meat, and braised food. However, many people ignore that too much soy sauce and oyster sauce are used in cooking at home, or they always order heavy takeaways. After eating, they are thirsty and cannot help but drink water. If there is not much urine output, the weight will increase by three or four kilograms between two dialysis sessions. During dialysis, if you lose weight quickly, you will easily get cramps and low blood pressure. If you lose weight, water will remain in the body and you can't breathe. All these are unnecessary sins.

I often tell patients I know well that the dietary taboos for uremia are never to memorize recipes, but to know more about your body's temperament. For example, if you eat something and your blood potassium and blood phosphorus are high during dialysis next time, you should eat two less bites next time. If you don't feel any discomfort after eating and your indicators are stable, there is no need to completely weld your mouth shut. After all, the good mood of eating well is as good for the disease as strict food control.