| Theme | Practicing proper nutrition for kidney diseases | |
|---|---|---|
| Title | Management of protein intake and hypertention to prevent the development of end-stage renal failure | |
| Publish Date | 1999/12 | |
| Author | Akihiko Kato | Department of Internal Medicine, Maruyama Hospital |
| [ Summary ] | Protein restriction and blood pressure control are currently considered to be defective ways of preventing the progression of chronic renal failure. A protein-restricted diet can reduce the appearance of uremic symptoms and may also postpone need for dialysis by a year or more. Another possibility is that strict protein restriction (less than 0.6g/kg of ideal body weight/day) coulds low the rate of deterioration in renal failure. The most attentive point in maintaining a low protein diet is providing an adequate intake of food energy (at least 35 kcal/kg of ideal body weight/day). To prevent the onset of malnutrition, the nutritional status of the patient should be assessed by measuring serum parameters (albumin, prealbumin, transferrin), body weight and midarm muscle circumference every three months. The most important method for continuing protein-restricted diets is to provide patient feedback on the adequacy of protein intake, using an estimating formula with twenty four hour urine collection. The control of blood pressure is most consistently associated with protection from renal failure. The target blood pressure in patients with proteinuria of more than 1g/day is 125/75 mmHg. Several sudies demonstrated that angiotensin converting enzyme inhibitors as well as calcium channel blockers could afford long-term renal preservation. Sodium intake also needs to be restricted to within 6g/day. |
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