Nephritis dietary taboos

First, you must not touch foods, drugs and supplements with unknown ingredients that are clearly nephrotoxic.； The second is to strictly control the total intake of salt, high-quality protein, phosphorus, and potassium based on kidney function, proteinuria, edema and hypertension. ； The third is to put an end to the bad eating habits of eating recklessly. All dietary adjustments must match your own disease stage, and do not blindly copy other people's recipes.

Two years ago, I met a 26-year-old young man with IgA nephropathy in the nephrology follow-up group. His urine protein was just found to be 2+, and his creatinine was still completely within the normal range. I heard a patient in the same ward say, "You should avoid protein in nephritis. Eating too much will increase the burden on the kidneys." So he went home and cut off all meat, eggs, and milk, and had white porridge every day. Served with stir-fried cabbage, after three months of reexamination, the urine protein did not drop, and the plasma albumin dropped directly to 28g/L. His lower limbs were so swollen that he felt like he was walking unsteadily. The doctor scolded him for a long time and asked him to eat at least one egg, half a catty of milk, and two taels of lean pork every day. It took more than a month to recover.

In fact, there is no completely unified conclusion in the academic community regarding the protein intake of patients with nephritis: the traditional KDIGO guidelines recommend that patients with chronic kidney disease whose glomerular filtration rate is lower than 60ml/min·1.73㎡ should control their daily protein intake to 0.6-0.8g per kilogram of body weight to avoid excessive metabolic waste and aggravating the burden on the kidneys.； However, many clinical studies in the past two years have also found that as long as the patient does not have large amounts of proteinuria (24-hour urinary protein quantification exceeds 3.5g), appropriately relaxing the protein intake to 1.0g per kilogram of body weight can actually reduce the risk of malnutrition and lead to better long-term prognosis. To put it bluntly, don’t cut out protein completely as soon as you start eating. Instead, give priority to high-quality animal proteins such as eggs, milk, and lean meat.

Many people just eat salt-free meals as soon as they get nephritis, which makes them feel bitter in their mouths and make them feel weak. In fact, it is completely unnecessary. As long as you don’t have edema, high blood pressure, and your kidney function is normal, it’s absolutely fine to eat 5g of salt a day (about the amount of a beer bottle cap). Just eat a few bites of pickles when you go out and don’t drink thick soup that’s been simmered for several hours. ； But if you are in the period of edema, or have high blood pressure that cannot be lowered, or have reached stage 4-5 of kidney disease, the salt must be limited to less than 3g. Invisible salts such as soy sauce, oyster sauce, and chicken essence must be included. Last time, an aunt said that she did not eat salt every day, but the blood pressure was still high. When I asked, I found out that if I put two tablespoons of light soy sauce in cooking every day, it does not mean that I have eaten a lot of salt.

Some red lines are really non-negotiable, and big problems may occur if they are touched. For example, Chinese herbal medicines containing aristolochic acid, such as Guan Mutong, Radix Fangchi, Aokixiang, etc., as well as some ancestral secret recipes and home remedies without batch numbers. Many people think that "Chinese medicines are not harmful to the body", but if they are eaten blindly, they will cause irreversible kidney damage. I have also encountered people who ate raw fish gallbladder to "clear fire" and ended up in ICU for dialysis due to acute tubular necrosis. This is really not the case. There are also those internet celebrity functional drinks and sports drinks. If your kidney function is already bad, really don’t touch them. Last summer, there was an uncle with a creatinine of 220 μmol/L. He sweated a lot while doing farm work. He drank three bottles of electrolyte drinks in a row. He collapsed and was sent to the emergency room due to hyperkalemia. He almost suffered cardiac arrest.

The problem of high potassium and high phosphorus that everyone is most worried about does not really require fighting against all the plants and trees. For example, everyone knows that bananas, oranges, spinach, and potatoes are high in potassium, but if you eat one orange segment or two bites of blanched spinach, it will not exceed the standard at all. On the contrary, if you do not eat fresh fruits and vegetables at all, the abdominal pressure will increase during constipation, which will increase the burden on the kidneys. If you really want to eat something high in potassium, cut it in advance and soak it in water for half an hour. When blanching, boil it for an extra two minutes. This can remove more than half of the potassium, and it will satisfy your craving. There are also high-phosphorus processed foods, such as milk tea, cakes, and processed meat products. The body absorption rate of the inorganic phosphorus in these is very high, so try to touch it as little as possible. However, the phosphorus in fresh lean meat and egg yolks is organic phosphorus, and the absorption rate is low. It is okay to eat it normally. There is no need to throw away the egg yolk and only eat the egg white. It is too wasteful.

After all, the dietary taboos for nephritis are never a cold list. The most reliable thing is actually your own body reaction and each review indicator. During each review, write down what you have eaten recently and whether you feel uncomfortable, communicate more with the doctor, and slowly figure out your tolerance. It is much better than not daring to eat anything based on the list on the Internet. After all, eating well and being in a good mood are the most useful for recovery.