Dietary Management For Acute Renal Failure
During recovery from acute renal failure, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Your doctor may refer you to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys. This article tells you about the dietary management and foods to be allowed and avoid for acute renal failure.
As your kidneys recover, you may no longer need to eat a special diet, although healthy eating remains important. Depending on your situation, your dietitian recommends that you choose:
Limit phosphorus: Phosphorus is a mineral found in foods, such as whole-grain bread, oatmeal, bran cereals, dark-colored colas, nuts and peanut butter. Too much phosphorus in your blood can weaken your bones and cause skin itchiness. Your dietitian can give you specific recommendations on phosphorus and how to limit it in your particular situation.
Avoid products with added salt: Lower the amount of sodium you eat each day by avoiding products with added salt, including many convenience foods, such as frozen dinners, canned soups and fast foods. Other foods with added salt include salty snack foods, canned vegetables, and processed meats and cheeses.
A minimum of 60-1000 kcal is necessary. A high calorie intake is desired, mainly from carbohydrates and fats.
All food containing protein are stopped if the patient is under conservative treatment and blood urea nitrogen is rising. However 40 g is allowed when he/she is on haemodialysis or peritoneal dialysis as it will reduce endogenous protein breakdown. Usually the protein content of the diet varies depending upon the urea content of the blood.
A minimum of 100 g/day is essential to minimise tissue protein breakdown. Two litres of 5% glucose meets this. If the patient is not fed by mouth, a nasogastric tube feeding of 700 ml of 15% glucose is administered. If orally given, 700 ml of glucose with lime juice can be given.
The total fluid permitted is 500 ml+losses through urine and gastrointestinal tract, with visible perspiration, an additional 500 ml may be necessary.
Sodium loss through urine is measured and replaced. Dilutional hyponatremia occurs due to water retention. Water restriction than salt administration is indicated. Therefore sodium restriction is also judged based on sodium loss in the urine.
Potassium intoxication (hyperkalemia) occurs with a daily rise of 0.7 m Eq serum potassium. It has deleterious effects on heart. A bowel wash may remove 100 m Eq of potassium. Potassium sources like:
- tomato juice
- cocoa and
- potassium rich vegetables are avoided.
Haemodialysis or peritoneal dialysis may be considered when blood urea level is over 200 mg/100 ml. The diet may then be raised to 2000-3000 kcal and 40 g protein. If the patient cannot take oral feeds, intravenous fat and amino acid solutions are given.
- Salt free butter
- Grape juice
- Low protein pudding