Food for hemodialysis patients

Food for hemodialysis patients

Hemodialysis is a form of renal replacement therapy that filters blood using a dialysis machine or a peritoneal dialysis catheter. Patients undergoing hemodialysis require adequate energy and protein intake. These patients lose about 1-2 grams of protein per hemodialysis session, which translates to 6-12 grams per day. Patients must consume protein to compensate for the loss. Protein intake should be increased to 1.1-1.4 grams per kilogram of body weight. Patients undergoing peritoneal dialysis should also consume adequate protein and energy to prevent Protein Energy Wasting (PEW), which can occur if protein and energy intake are inadequate.

The condition of protein and energy malnutrition (PEW)

The condition of protein and energy malnutrition (PEW) is related to several factors, including abnormalities in the body's metabolic processes and the dysfunction of glands, the accumulation of waste products, inflammation, pre-existing diseases, and even blood purification. PEW not only leads to weakness but also affects the nutritional indices in the blood, such as albumin, pre-albumin, and cholesterol. The decrease in muscle mass resulting from PEW also leads to an increased risk of death, and infections can cause a deterioration in the patient's quality of life.

According to a report from the Thai Kidney Foundation, 8-33% of patients who receive kidney replacement therapy have a high prevalence of PEW. To prevent this condition, it is essential to manage the acid-base balance in the blood and ensure that the patient receives adequate nutrition, including both energy and protein. High-quality protein sources from animal products such as egg whites, fish, pork, and chicken should be chosen. The recommended daily protein intake is 4-6 egg whites per meal or 4-6 tablespoons of animal protein per meal to meet the body's requirements.

            Protein albumin is important in preventing edema and building the immune system. It should be consumed sufficiently in order to be beneficial.

            Phosphorus is found in milk and milk products, dried beans, and some types of meat. If phosphorus is abnormal, it can affect the bones and make them weak and easily broken, as well as cause hardening of the arteries.

            Omega-3 fatty acids, found in fish, help reduce inflammation and lower the risk of heart disease and stroke. Fish should be consumed at least once a day, with a portion of 100 grams, to increase the intake of omega-3.

            Water and liquids: the patient’s body should be weighed every morning. The weight should not increase by more than 0.5 kilograms per day. If it increases by 1 kilogram per day, it indicates the need to limit water intake.