Patient's question:
What supplements should people with nephrotic syndrome eat?Doctor's answer:
What are the dietary restrictions for kidney patients?A reasonable diet plays a very important role in the recovery of kidney diseases. What should kidney patients eat? How much is appropriate? This cannot be explained in one sentence. The plan must be tailored to each individual based on the type of disease and the severity of the condition.
1. Can kidney patients eat salt and alkali?
Normal adults consume about 5–6 grams of salt per day, while in some regions, people eat up to 12 grams per day. Salt is sodium chloride, alkali is sodium carbonate, and baking soda is sodium bicarbonate. Excessive intake of sodium-containing salt and alkali can easily lead to water retention in the body, causing edema. Therefore, kidney patients with edema should control their salt and alkali intake, consuming only 2–3 grams of salt per day for a low-salt diet. A completely salt-free diet is not scientific either, as it can lead to fatigue and dizziness over time.
2. How much water should kidney patients drink?
Normal urine output is usually 1–2 kilograms per day. During acute nephritis, acute kidney failure with oliguria, nephrotic syndrome, or chronic kidney failure with oliguria and edema, water intake should be controlled. If the consumed water cannot be excreted, it will accumulate in the body, worsening edema and high blood pressure. In such cases, water intake should be limited to urine output plus 500 milliliters. Once urine output increases, water intake can be relaxed. Patients with normal urine output have no restrictions on water intake. Additionally, patients with urinary tract infections, such as acute pyelonephritis, urethritis, or cystitis, should drink more water and urinate frequently to aid recovery, in addition to seeking timely medical treatment and medication.
3. Can kidney patients eat fish, shrimp, eggs, and meat?
Some kidney patients avoid fish and shrimp, believing they are harmful to the kidneys. However, these foods are high-quality protein. Patients with allergic conditions, such as allergic purpura or purpura nephritis, should use caution due to suspected allergic reactions to foreign proteins or a history of fish/shrimp allergies. Generally, there is no need to avoid these foods. Fish, shrimp, eggs, and meat are rich in animal protein, which are essential for the construction of human cells and tissues. After consuming protein-rich foods, the liver breaks them down, and the kidneys excrete them. Therefore, when kidney function declines, protein intake should be reduced appropriately to meet metabolic and nutritional needs without overburdening the kidneys. Some patients may avoid protein due to mild kidney disease, or they may disregard protein restrictions when the condition requires it—both are incorrect.
4. Some kidney patients have long-term conditions with slow recovery, often discussing and sharing information. It should be noted that each person has unique characteristics and should not imitate others.
5. Avoid overeating and consuming unclean food.
### > Dietary Restrictions for Kidney Diseases
1. Recommended: Light and easily digestible foods; avoid seafood, beef, mutton, spicy, irritating foods, alcohol, and all allergenic foods such as five-spice powder, coffee, and coriander. This is especially important for patients with yin deficiency, such as those with red tongues, large pulses, night sweats, dry stools, and hematuria. However, patients with yang deficiency, such as those with pale tongues, white coatings, deep pulses, cold limbs, loose stools, may consume warm foods.
2. Recommended: Fresh vegetables and moderate fruits; drink water appropriately; avoid all tonics, supplements, and easily irritating foods such as chili peppers, lychees, and chocolate. This is particularly important for patients with yin deficiency and internal heat, such as those with purple tongues, stagnant pulses, chest tightness, and abdominal distension.
3. Forbidden: All kidney patients should avoid neomycin, streptomycin, gentamicin,, and autoimmune injections.
4. Uremic patients: Maintain smooth bowel movements, with 2–3 bowel movements per day. Avoid staying up late, excessive sexual activity, and fatigue; avoid cold exposure.
5. Patients on hormones: Gradually reduce hormone dosage and frequency under the guidance of a doctor based on specific conditions.
6. Severe edema: Avoid salt, limit protein intake, and reduce water consumption. For mild edema, a low-sodium diet is recommended. Without edema, there are no restrictions on water and protein intake. Patients with microscopic hematuria or those prone to heat should drink more water and consume foods that nourish yin and reduce heat, such as apples, white sugar, black sesame, and black fungus.
7. Uremic patients with high potassium: Avoid high-potassium foods such as bananas, oranges, potatoes, tomatoes, pumpkin, tea, soy sauce, and MSG. Patients with low potassium should do the opposite.
8. Patients with high uric acid: Avoid animal organs, fish, shrimp, crabs, clams, beer, mushrooms, beans, and spinach.
9. During treatment: If symptoms such as colds, fever, or infections appear, contact a specialist doctor promptly to avoid complications.
### > Diet for Kidney Patients
1. Diet: Eat lightly; avoid alcohol and spicy foods; consume less greasy and high-animal-protein foods (e.g., fatty meat, shrimp, and crabs).
2. Avoid: Beans and their products (e.g., tofu, bean sprouts, and bean flour).
3. For edema and high blood pressure: Follow a low-salt or salt-free diet.
4. For patients with impaired kidney function and uremia:
- Forbidden: Beans and their products; limit nuts (e.g., walnuts, chestnuts, and almonds) and pickled foods (e.g., pickled vegetables and pickles).
- High-protein foods (e.g., lean meat, milk, and eggs) should be controlled in quantity. For adults, 2–3 ounces per day, divided into 3–5 meals.
- Kidney failure: Due to limited water excretion, fluid intake should be controlled. Use the formula: Fluid intake = total urine output the previous day + 500–800 milliliters.
- To increase the excretion of creatinine and urea nitrogen, ensure smooth urination and defecation. Prefer 2–3 bowel movements per day over one every 2–3 days.
- Diuretic foods: Winter melon, watermelon, and gourd.
- Clearing heat and diuretic soups: Red bean soup, black bean soup, green bean soup (sweetened).
- Laxative foods: Honey, bananas, pears, radishes, walnuts, black sesame. These can be used alongside medication for regular consumption.