Hemodialysis is one of the important therapeutic measures for patients with patients. However,maintenance hemodialysis patients are easy to cause water retention, hyperkalemia,congestive heart failure and death in the clinical, because diet nursing is not reasonable. Diet nursing plays an important role under treatment, reasonable and exact diet guide not only prevent or reduce to appear complications, maintain good state of nutrition,also improve the dialysis effect and anemia to get a better goal for the treatment,and enhance to adjust daily life and social active ability for patients,and develop patients’ living quality.
With the development of renal replacement therapy, the mortality of patients with end -stage renal disease is still high, malnutrition stands the important position in many factors for affecting death. Patients should know dialysis is the intermittent treatment for renal failure, the control of diet and liquid volume is the sustainable treatment. Reasonable and effective diet guide is very important. Patients should maintain the principle of the following diet: the diet of high quality high protein,high quantity of heat, maintaining the balance of the water,tall vitamin,low sodium, low potassium, high calcium, low phosphorus.
1、Getting enough protein
Hemodialysis can lose a certain amount of protein and amino acid , and promote protein catabolism to cause negative nitrogen balance. Patients should eat high quality high protein(such as egg white, milk, lean meat, fish and other animal protein), the human body essential amino acid content synthesis of body protein utilization in such high quality protein than plant protein are higher,and produce less waste products like urea. The intake of protein is suitable in 1.2-1.4\kg body weight every day.
2、Getting enough quantity of heat
Enough quantity of protein can restrain alienation of protein and maintain ideal weight. If the heat is not enough, protein in food and their protein like mascle act as the heat source to be consumed, heat is mainly supplied by carbohydrate and fat for patients with maintenance hemodialysis. The intake of heat is appropriate in 33-35kcal\kg body weight every day.
3、Maintaining the balance f water
A majority of patients with maintenance hemodialysis is oliguria or anuria, they should control strictly intake of water. To maintain the balance of water is important link to prevent complications and improve survival rate. The interphase of dialysis flooding water more can cause water retention,high blood pressure, congestive heart-failure and so on, the middle period of dialysis with too much ultrafiltration can cause low blood pressure, angina pectoris, arrhythmia,muscle spasm and other complications.
4、Limiting to intake salt
Patients can comply with the requirement of the liquid limit, it depends on intake of sodium,for patients with maintenance hemodialysis, limiting salt is more important than limiting water, fir example, suitably limiting salt in the food can prevent thirst, reduce intake of water.
5、Limiting to intake potassium in the food
Hyperkalemia have toxic effect on myocardial cells, it can induce arrhythmia,serious patients can cause cardiac arrest and ventricular fibrillation.Patients should pay special attention to potassium in food,and avoid high potassium foods(such as vegetables, fruits, nut fruits, potato, mushroom, cocoa, chocolate, soluble coffee and so on)to reduce intake of potassium in food.Steeping, boiling, cryogenic refrigeration and other ways can get rid of potassium in food, they should monitor the concentration of potassium, they should adjust intake of potassium according to urine volume to avoid too high or too low potassium.
6、Limiting to intake phosphorus
The intake of phosphorus is in 600-1200 mg every day, patients should eat high calcium food of low phosphorus,food containing phosphorus such as egg yolks, liver marrow, nuts,should avoid eating much.