What is best to eat for chronic renal failure?

Written by Zhang Hui
Nephrology
Updated on September 16, 2024
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Patients with chronic renal failure are advised to adopt a low-salt, low-fat, and high-quality protein diet. For those not undergoing dialysis, protein intake should be strictly controlled to 0.6 to 0.8 grams per kilogram of body weight per day. Additionally, patients with stage 3 CKD or above often experience electrolyte disorders, such as hyperkalemia, which can lead to cardiac arrest and arrhythmias. Therefore, it is important to avoid foods high in potassium, such as bananas, oranges, dates, kiwis, and tomatoes. Due to the strict protein intake, hypoproteinemia may occur, and these patients are also prone to hyperphosphatemia. It is recommended to choose foods with a low phosphorus to protein ratio, generally those with a ratio below fifteen. After starting dialysis, the same principles apply, but protein intake can be slightly increased, as some protein is lost during both hemodialysis and peritoneal dialysis. The protein intake can be adjusted to 1.0 to 1.2 grams per kilogram of body weight per day, while still controlling phosphorus and potassium intake.

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Written by Zhou Qi
Nephrology
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Does chronic renal failure require dialysis?

Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.

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Written by Zhou Qi
Nephrology
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What are the symptoms of chronic kidney failure?

Chronic kidney failure generally may have some clinical symptoms, but many patients do not have any discomfort. Some common clinical symptoms mainly include increased urine foam and decreased urine output. Due to the decline in renal function for urine excretion, it can lead to edema, particularly in areas such as both ankles and the face. In the state of renal failure, patients may also experience hyperkalemia and metabolic acidosis. Due to metabolic acidosis, patients might exhibit deep and labored breathing. In the advanced stages of kidney failure, patients may suffer from renal anemia, leading to fatigue and potentially experiencing bone pain and susceptibility to fractures due to renal osteodystrophy.

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Written by Zhang Hui
Nephrology
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What should I do about coughing caused by chronic kidney failure?

Patients with chronic renal failure who experience coughing should first analyze whether it is caused by an infection. In such cases, routine blood tests and chest CT scans are needed to confirm whether there are any infectious lesions in the lungs. Additionally, it should be checked whether the patient has systemic lupus erythematosus, vasculitis, or other conditions, as these diseases can affect the lungs and cause pulmonary lesions leading to coughing. Therefore, treatment should be targeted based on the cause. If the cough is due to an infection, antibiotics are required, but the dosage must be adjusted according to the patient's kidney function. If the cough is due to pulmonary changes caused by a systemic disease, targeted treatment for the systemic disease is needed.

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Can chronic renal failure reproduce?

Patients with chronic renal failure, if they are male, can attempt to conceive under the guidance of a clinic doctor after discontinuing the use of medications that affect fertility; usually, there are no major issues for male patients. However, for female patients, attempting to get pregnant carries a significant risk because pregnancy increases the burden on all organs, including the kidneys, which can exacerbate kidney diseases, especially in cases like lupus nephritis. Nevertheless, not all patients with chronic renal failure are absolutely unable to conceive; some have successfully managed the risks associated with pregnancy. In such cases, it is necessary to weigh the pros and cons.

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Written by Zhou Qi
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Can patients with chronic renal failure have sexual intercourse?

Patients with chronic renal failure can have sexual intercourse, but there are prerequisites. Since sexual activity is physically demanding and requires adequate cardiopulmonary function, patients can engage in sexual activity if they do not experience chest tightness or shortness of breath and their blood pressure is well controlled. If there are no obvious symptoms of fatigue, difficulty breathing, or chest tightness during sexual activity, there should be no significant problems. However, since the patients have chronic renal failure, it is advisable to avoid conception unless prepared for pregnancy. Pregnancy can further burden the kidneys in female patients and potentially exacerbate chronic renal failure. Male patients with chronic renal failure may be taking medications that could affect sperm quality. Therefore, contraception should be practiced unless preparations have been made.