Therapeutic nutrition for diabetic nephropathy. Raw materials and seasonings

To reduce symptoms and correct clinical picture A diet is necessary for nephropathy. Any disease of the excretory system disrupts the normal functioning of many organs. The diet should contain low protein and low carbohydrate foods. Thanks to a competent balanced diet, the effects of medications are improved and metabolic processes in the body are normalized.

In the early stages of the disease, rational balanced nutrition. In case of advanced disease, a therapeutic diet is necessary.

A dietary menu is recommended after examining the patient. Balanced diet makes it possible to restore water-salt balance in the body. A properly compiled list of dishes helps excretory system function normally, swelling of the arms and legs decreases. Blood pressure stabilizes, the amount of toxic substances in organism.

The diet for diabetic nephropathy is based on the following principles:

• Reducing animal proteins in the menu and completely switching to vegetable protein.
• Limiting salt intake.
• At increased content mineral potassium (K) in the bloodstream, it is necessary to reduce foods with high content of this substance.
• If there is a reduced level of potassium (K) in the bloodstream, you should increase your intake of foods containing this trace element.
• Food restrictions from high concentration phosphorus.
• Canned, richly spiced, fatty, smoked and pickled foods are excluded from the diet.
• Consuming a sufficient amount of clean drinking water.
• Eating should be frequent.
• Vitamins, minerals, and foods rich in iron must be present in the diet.
• Limit the amount of sugar and easily digestible carbohydrates.

About the KBZHU index

KBZHU is calculated for each individual person, taking into account his characteristics.

For nephropathy, nutrition should be high in calories and should be 3500 kcal per day. You should eat foods high in vegetable fats And slow carbohydrates. A decrease in caloric content leads to the fact that the body begins to consume its own proteins, resulting in poisoning with harmful substances formed during these reactions. In this regard, the load on the kidneys increases.

To correctly calculate calories, fats, carbohydrates, proteins that enter the body with food, there is a KBJU index. For each patient, the index is calculated individually, taking into account age and goals. Using the numerical values ​​of the product composition, you can calculate the calorie content. For example, a 10 g piece of hard cheese contains 2.4 g of protein, 3 g of fat and 0.2 g of carbohydrates. Calorie content is calculated using the following formula: 2.4×4+30×9+0.2×4=37 kcal.

Diet for kidney nephropathy: what is possible and what is not

Grocery list

• dietary bread products that do not contain salt;
• vegetable, vegetarian, dairy, fruit;
• low fat dairy products;
• meat low-fat varieties;
• lean varieties of fish.

If you have nephropathy, you should not eat radishes.

In case of nephropathy, the following foods are excluded:

• baked goods;
• fat cottage cheese, sour cream, milk;
• Radishes and legumes are prohibited among vegetables;
• smoked, spicy, marinated dishes.

Drinking regime

The required amount of fluid helps remove salts uric acid and stabilizes metabolic processes. It is important to follow a drinking regime. Daily required drinking plenty of fluids fluids to increase urine output. This liquid is distributed evenly throughout the day. It is useful to drink clean water, tea, herbal infusions, such as chamomile flowers, and rosehip infusions throughout the day. Excluded from the diet mineral water, cocoa, strong tonic drinks.

Nutritional considerations for certain types of illness

It is important to follow a special diet for IgA nephropathy ( chronic glomerulonephritis non-infectious nature), accompanied by complications in the functioning of many systems in the body. With this disease, negative changes are experienced the cardiovascular system, bone, liver gastrointestinal tract. The goal of proper balanced nutrition for this disease is to reduce blood pressure, strengthening the immune system, increasing the supply of necessary nutrients. It is important to exclude animal protein and fat, and light carbohydrates from the menu.

People with diabetic nephropathy should avoid dried fruits.

In case of diabetic nephropathy, accompanied by an increase in sugar levels in the bloodstream, it is necessary to reduce the load on the kidneys. A balanced diet for this disease involves regulating sugar in the bloodstream, for which a low-carbohydrate diet is used. The list of products prohibited for patients is as follows:

• sugar;
• dried fruits;
• fruits containing large amounts of sugars;
• baked goods;
• sweet coffee, tea.

Diabetes mellitus is endocrine disease, which requires a careful approach. Besides drug therapy, the patient needs diet therapy in order to protect his body from complications on target organs.

Renal failure in diabetes mellitus is quite common, because with regularly elevated glucose in the blood, it takes fluid with it, thereby increasing the pressure inside the glomeruli. If you do not bring your blood sugar level back to normal, the disease can lead to complete loss of kidney function. The patient will require regular dialysis.

Below we will look at five signs of the onset of kidney failure in diabetes mellitus and how to improve functioning with diet of this body, a diet for chronic renal failure is described and an approximate weekly menu is presented.

Regularly high blood sugar levels over a long period of time have a negative impact on the kidneys. Usually occurs renal failure in diabetes of the second type, when glycemia goes hidden and is not treated.

Diabetes and kidneys are interrelated concepts. This is explained quite simply - excess glucose excretion creates pressure inside the glomeruli of the kidneys. Their shell thickens over time, which displaces blood vessels. Such a physiological disorder entails inadequate blood purification. If left untreated, this disease can become chronic, and the patient will subsequently need dialysis.

Dialysis is a procedure performed in medical institutions using a machine to cleanse the blood. Dialysis for chronic renal failure is vital, its duration is prescribed only by a doctor. To identify kidney problems in diabetes mellitus, you should pay attention to the following symptoms:

nausea; reduction in the number of urinations; vomit; regular headaches; convulsions.

If you observe these symptoms, or at least one of them, you should immediately contact a nephrologist. If kidney function in diabetes mellitus is impaired due to the loss of normal nephrons, then this pathology called renal failure.

To prevent the disease, non-insulin-dependent patients should regularly check whether their blood sugar is high. For primary prevention of the disease, treatment is prescribed to reduce glucose concentrations. The endocrinologist prescribes diabetic medications (Metformin, Glucobay) and a special diet based on the glycemic index (GI).

To prevent such complications on the kidneys in diabetes mellitus, it is worth visiting an endocrinologist and nephrologist annually.

Sugar level

A kidney diet for diabetes should be low-carbohydrate and contain minimal amount animal protein. Such nutrition does not allow glucose in the blood to increase, thereby improving and at the same time not burdening the functioning of the kidneys.

Diabetes mellitus itself obliges a person throughout his life to adhere to diet therapy based on the choice of foods based on GI. This indicator digitally displays the effect of a food product on blood glucose levels after consumption.

In the second type of diabetes, diet acts as the main treatment, and in the insulin-dependent type it is a concomitant treatment that complements insulin therapy.

GI is divided into several categories:

0 – 50 units – low indicator; 50 – 69 units – average; 70 units and above is a high indicator.

When a person has high sugar, he should complete failure from foods with high GI. The main diet is formed by foods with low GI, food with average indicators is allowed to be included in the menu as an exception several times a week.

At wrong diet When a patient eats quickly digestible carbohydrates, not only blood sugar can be increased, but also vascular blockage can occur, since such food contains bad cholesterol.

When a patient is diagnosed with acute renal failure and regularly has high blood sugar, it is important to eat foods with a low glycemic index.

When sugar is elevated, the patient should make every effort to reduce it, because this damages not only the functioning of the kidneys, but also other vital functions. important organs. Important factor influence on blood glucose levels is the nutritional system.

A properly composed menu not only improves the patient’s health, but also eliminates various symptoms manifestations of the disease. It is important for a patient undergoing dialysis to reduce their daily protein intake, which should not exceed 70 grams.

It is better not to add salt to dishes when cooking; if possible, reduce salt consumption to a minimum. You should drink a liter of purified water per day.

Basic diet rules:

eating small portions 5 – 6 times a day; exclude strong teas and coffee from the diet; moderate fluid intake; permitted daily norm animal protein does not exceed 70 grams; eat no more than 150 grams of fruits or berries daily; exclude spices from the diet and spicy foods; eat food only warm; give up foods containing high amounts of oxalic acid, potassium and calcium - they put additional stress on the kidneys; The last meal is at least a few hours before going to bed.

boil; steamed; simmer in water or with minimal use of olive oil; bake in the oven.

When a patient undergoes dialysis, the doctor can slightly adjust the diet for an individually set period, based on the clinical picture of the disease.

As described earlier, foods that contain high amounts of potassium and calcium are excluded from the diet. Such substances require the kidneys to work harder, but with chronic kidney disease this is not possible.

You should completely avoid the following products:

potato; any types of dried fruits; legumes - peas, lentils, chickpeas, beans; cocoa powder, coffee and tea; spinach; all types of nuts; wheat; soybeans

To compensate for the deficiency of potassium and calcium, the nephrologist prescribes special drugs. In this case, self-medication is prohibited.

Below is a diet for kidney failure and diabetes, a menu for a week, which can be changed according to personal taste preferences. But do not forget about the above recommendations.

You should approach it with all responsibility when preparing a patient’s diet, because it is impossible to assess how important it is to follow all the rules and principles of diet therapy.

first breakfast – slice rye bread, tofu cheese, tea; second breakfast – baked apples, 150 ml of kefir, a glass of purified water; lunch – vegetable soup, barley with fish cutlet, tea; afternoon snack – boiled egg, vegetable salad, glass of water; first dinner – stewed cabbage with brown rice; second dinner - cottage cheese soufflé. first breakfast – vegetable salad, tea; second breakfast will consist of cheesecakes without sugar and tea, one pear; lunch – vegetable soup, buckwheat with boiled chicken breast, a glass of water; afternoon snack – vegetable salad, a slice of rye bread, a glass of water; first dinner - vegetable stew, slice of rye bread, tea; second dinner – cottage cheese with fermented baked milk. first breakfast - one apple, skim cheese; second breakfast – oatmeal with water, baked apples, a glass of water; lunch - soup with brown rice, pike on a bed of vegetables, a slice of rye bread, tea; afternoon snack – omelette with vegetables, tea; first dinner - barley porridge with gravy from chicken liver, tea; second dinner - unsweetened yogurt. first breakfast - 150 grams of fruit salad, tea with a slice of rye bread; second breakfast – oatmeal with water, tea; lunch – vegetable soup, steamed vegetables, boiled squid, tea; afternoon snack – jelly made with oatmeal, a slice of rye bread; first dinner - boiled beef tongue, viscous wheat porridge with water, tea; second dinner - a glass of any low-fat fermented milk product. first breakfast – berry salad, tea; second breakfast – omelet with vegetables, a glass of water; lunch – durum wheat noodle soup, pearl barley, boiled quail, tea; afternoon snack - baked apples, tea, a slice of rye bread and tofu cheese; first dinner - stewed vegetables in a pan with chicken, tea; second dinner - cottage cheese soufflé, glass of water. first breakfast – 150 grams of any vegetables or berries (low GI); second breakfast – oatmeal with water, tea; lunch – vegetable soup, boiled beef, buckwheat, tea; afternoon snack – a slice of rye bread, tofu cheese, tea; first dinner - omelette with vegetables, a slice of rye bread, weak coffee4 second dinner - baked apple, tea. first breakfast - fruit salad, 150 ml of fermented milk product; second breakfast – brown rice with vegetables, tea; lunch – soup with buckwheat, boiled fish cutlet cauliflower, tea; afternoon snack – a slice of rye bread and chicken liver pate for diabetics, tea; first dinner - vegetable stew, boiled egg, tea; second dinner - 150 grams of oatmeal with water.

The video in this article continues to cover the topic of diet for kidney failure.

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Kidney failure is a condition in which, for various reasons, kidney function is impaired. The cause of acute renal failure is intoxication, acute infections, burns, injuries and acute nephritis.

It has 4 periods: initial, diuresis reduction, its restoration, recovery. The period of decreased diuresis is the most severe, it lasts up to 20 days and is characterized by the accumulation of nitrogenous waste in the blood, disruption of water and mineral metabolism, and the appearance of swelling and development acidosis. Patients with acute failure kidneys may refuse food because they are bothered by nausea and vomiting. Hunger aggravates the situation, as protein breakdown accelerates and metabolic disorders intensify.

Chronic renal failure associated with deterioration of kidney function due to their pathology, which is constantly progressing. It can be caused by chronic diseases:

glomerulonephritis; urolithiasis disease; pyelonephritis; tumors; systemic diseases; diabetes; arterial hypertension; gout and hereditary diseases.

Risk of chronic acute glomerulonephritis in adults the outcome in chronic renal failure is 10 times higher than in children. Pyelonephritis occupy third place among the causes of chronic renal failure.

Anemia often accompanies chronic kidney disease and is the most early complication chronic renal failure. More often observed with decreased clearance creatinine up to 40-60 ml/min (in stage III). Sometimes it is observed in earlier stages. Its degree is especially pronounced in the terminal stage of insufficiency.

The condition of these patients is serious; they are forced to undergo constant treatment and carefully monitor their diet. Let's figure out what diet is prescribed for kidney diseases accompanied by renal failure. Main treatment table is Diet 7 or its variations No. 7A And No. 7B.

At acute renal failure The main table is Table No. 7A, which provides:

Significant protein restriction (20 g). The patient receives this amount from milk, fermented milk drinks, cream, sour cream and eggs. Meat and fish are excluded. Meeting energy needs by consuming carbohydrates (fruits, berries, vegetables, sugar, sago, rice, honey) and fats (butter and vegetable oil). Administration of 0.4-0.5 liters of liquid (still water, weak tea, diluted juices, kefir) and salt restriction when diuresis ceases. During the recovery period, the amount of urine can be 2 liters per day, so increased fluid intake is recommended. Inadequate or excessive fluid intake aggravates renal dysfunction. Limit foods containing potassium and magnesium, and in the presence of anuria, additionally sodium. As you recover, gradually introduce salt and protein - first up to 40 g ( Table No. 7B), and then to normal. After this table, the patient is transferred to Diet No. 7 for a long period(up to a year). In case of mild acute renal failure, Table No. 7 is immediately recommended, but with potassium restriction.

At chronic renal failure The diet protects the kidneys and the basic principles of nutrition are:

Baked boiled meat

Varying degrees of protein restriction (this depends on the severity of chronic renal failure). Preferred, as they are more easily digestible, are milk proteins and egg whites. Plant proteins have less nutritional value. When cooking, meat and fish are first boiled and then stewed or baked. This technique reduces the amount of extractives. Limit the intake of phosphorus (milk, bran, cheese, muesli, whole grain bread, eggs, legumes, cottage cheese, cereals, nuts, cocoa) and potassium (limit potatoes, sorrel, bananas, fruit juices, sea fish, meat, exclude curry, seeds, sesame). Sufficient calcium intake (dairy products, eggs, vegetables). The best way out is to take calcium carbonate, which is well absorbed and binds phosphorus in the intestines. Daily dose the drug is calculated individually. Addition of keto analogues of essential amino acids and histidine. Their use allows you to safely limit protein. Ensuring sufficient energy value from fats (polyunsaturated fatty acids) and carbohydrates, which improves protein absorption and reduces its breakdown in the body. When there is a lack of calories, proteins are included in the metabolism and urea levels rise. You need to include high-energy foods (sour cream, honey) in your diet, but consume them in the first half of the day. At the same time, do not load the diet with refractory fats and large amounts of simple carbohydrates. Taking into account the state of the selection function and optimal administration liquids and salts. Limiting them in the presence of edema and high blood pressure. Food is prepared without salt, but a certain amount is allowed to be consumed (this depends on the severity of the disease and the severity of renal failure). The exact amount of fluid is calculated individually based on the amount of urine excreted over the past day. Products with essential oils(celery, fresh dill, parsley, basil, garlic and onion in fresh). Limiting foods containing potassium (dried fruits, fresh vegetables and fruits), since patients with impaired renal function develop hyperkalemia. Limit dairy products, cereals and pasta. Avoid strong tea and coffee, spicy and salty foods, cocoa, chocolate, cheeses, alcoholic drinks. Inclusion of vitamin complexes and amino acids. The intake of sodium mineral waters is excluded.

At chronic failure kidneys, with the help of proper nutrition, you can reduce intoxication and progression of chronic renal failure, reduce the manifestations hyperparathyroidism. Dietary therapy should be prescribed at an early stage, when creatinine just begins to exceed the normal limit.

The diet for chronic renal failure depends on the degree of renal failure and includes the amount of protein that will not lead to an increase in azotemia, and at the same time will not cause the breakdown of its own proteins. Therapeutic nutrition should meet the need for amino acids with low protein content, which means preventing protein deficiency. Early dietary protein restriction may slow the progression of the disease. Reducing the protein load inhibits hyperfiltration (one of the mechanisms of chronic renal failure progression), when the preserved part of the kidney tissue takes over increased load protein. A low-protein diet reduces hyperfiltration. By limiting protein intake, the level of urea (the end product of its breakdown) decreases, intoxication decreases and the condition of patients improves.

Protein-free bread

IN initial stage(at 1st degree) meals are carried out on the basis of Table No. 7, but bread is replaced with protein-free bread. The protein content in the diet is 0.8 g per 1 kg of patient weight (50-60 g per day and half of this is animals). This average amount of protein may be reduced depending on the patient's condition. The patient is recommended to have fasting days (up to 3 times a week) Diet 7B with reduced protein content. No amino acid supplements are required during this period.

Fluid intake during normal urine separation is not limited, but it should correspond to the amount excreted over the past day plus 400-500 ml. If the blood pressure is not elevated and there is no swelling, 4-5 g of salt per day is recommended. With increased blood pressure, the appearance of edema and weight gain, reduce fluid and salt intake.

For stage 2 chronic renal failure, protein restriction to 0.5-0.4 g/kg body weight is required ( Table No. 7B), as well as phosphorus. For this reason, they are excluded egg yolk and poultry, cheeses, nuts, legumes, milk is limited. Beef, fish, rice and potatoes should be boiled twice in plenty of water, discarding the first water. This technique allows you to reduce phosphates by almost half. There are special tables for calculating the amount of protein and potassium. Amino acid supplements are prescribed in the form of a drug Ketosteril(4-8 tablets three times a day). The calcium salts that are present in it bind phosphates in the intestines.

For stage 3 chronic renal failure it is used Diets No. 7A or No. 7B. They contain 20-25 g or 40 g of protein respectively. These are mainly animal proteins (dairy products, eggs, fish and meat). The length of time spent on a low protein diet depends on the patient’s condition; if it improves, it is allowed Table No. 7B, but against this background they periodically (up to 3 times a week) return to low-protein Table No. 7A.

The amount of salt can be increased to 6-8 g or more, but under control blood pressure and excreted urine (if its amount has decreased, then the salt is not increased). The above diets do not meet the patient’s need for vitamins, iron, and calcium, so nutrition must be supplemented with appropriate medications. To normalize the disturbed metabolism of phosphorus and calcium, it is important to reduce phosphorus in the diet and increase calcium, which has a positive effect on the condition of the kidneys. Legumes are excluded due to their high phosphorus content. Calcium is additionally administered in the form of drugs. It is not recommended to consume fresh vegetables and fruits due to high content potassium, they need to be boiled.

In case of terminal stage 4, the patient is transferred to treatment hemodialysis, therefore, the amount of protein increases to 1.0-1.3 g/kg of weight, since in the process of blood purification they are lost amino acids, vitamins, trace elements and oligopeptides. The diet should be as complete as possible. The energy value of food increases, which is achieved by consuming more carbohydrates (450 g) and fats (90 g). Additionally, amino acids are introduced in the form of preparations.

The amount of fluid is compared with diuresis. If renal excretory function deteriorates, fluid restrictions are introduced. Salt intake is limited to 5-7 g, but it is usually calculated individually, taking into account arterial hypertension and swelling. It is recommended to exclude salted meat and fish, cheeses, canned food, salted butter and regular bread from the diet. Particularly common in dialysis patients hyperphosphatemia.

Patients experience decreased appetite, nausea, vomiting, and changes in taste sensations. The esophagus and stomach are often affected, so dishes should be predominantly boiled or steamed, and to enhance the taste, sauces (sweet and sour), spices, and spicy vegetables are used. Often used fasting days(apple, apple-pumpkin), which helps reduce acidosis And azotemia.

A characteristic complication diabetes mellitus is nephropathy. In some countries, diabetic nephropathy has become the leading cause of death in older people from chronic kidney disease. Treatment of such patients poses great difficulties. In case of renal failure and diabetes mellitus, blood pressure control and correction are important metabolic disorders (hyperlipidemia, hyperuricemia). Carbohydrates in the diet of such patients are limited.

Diet No. 7B most often used for insufficient renal function. From Diets No. 7A characterized by an increase in the amount of protein, general diet and calorie content. Dishes Stolov No. 7A And No. 7B prepared without salt.

It is allowed to consume protein-free and salt-free bread made from maize starch up to 300-400 g per day. If it is not available, you can use achloride bread. Soups are only vegetarian with the addition of cereals and vegetables; you can prepare cabbage soup, borscht and beetroot soups. Portion - 250-350 ml. Lean beef, chicken, veal and turkey are served boiled. After boiling, the meat can be baked or fried. Pre-boiling in large quantities of water removes nitrogenous substances from foods. Portion 55-60 g. Choose low-fat fish: pike, pike perch, hake, navaga, pollock, cod. It is prepared in the same way as meat, the portion is the same. Carrots, cucumbers, beets, dill, tomatoes, cauliflower, lettuce, parsley are allowed for vegetable side dishes. green onions, tomatoes, potatoes, cabbage. Vegetables are boiled or stewed. Cereals, all legumes and pasta are sharply limited in the diet. Recommended dishes made from sago on water are in the form of puddings, porridges, casseroles, pilaf or cutlets. Protein omelet from one egg per day. Fruits and berries are different in raw and boiled form. Potassium content is taken into account if a limitation is assigned. Potassium is lost when fruits are boiled. With your doctor's permission, you can consume dried apricots. If there are no restrictions, milk and fermented milk products are consumed up to 200-300 g per day. Cottage cheese is excluded or consumed in small quantities (up to 50 g). White sauce with sour cream or milk, salads from vegetables and fruits, vinaigrette without salted vegetables are allowed. Weak tea and coffee, fruit juices, rosehip infusion. Butter and vegetable oil.

Vegetables and greens

zucchini0,60,34,624cauliflower2,50,35,430potatoes2,00,418,180carrots1,30,16,932beets1,50,18,840tomatoes0,60,24,220pumpkin1,30,37,728

Fruits

watermelon0.60.15.825melon0.60.37.433figs0.70.213.749apples0.40.49.847

Berries

strawberry0,80,47,541

Nuts and dried fruits

raisins 2.90.666.0264 dried apricots 5.20.351.0215 apricots 5.00.450.6213 dates 2.50.569.2274

Cereals and porridges

buckwheat (kernels) 12.63.362.1313 white rice 6.70.778.9344 sago 1.00.785.0350

Confectionery

jam0,30,263,0263jelly2,70,017,979milk candies2,74,382,3364fondant candies2,24,683,6369marshmallow0,50,080,8310

Raw materials and seasonings

cinnamon 3.93.279.8261 honey 0.80.081.5329 dried parsley 22.44.421.2276 sugar 0.00.099.7398 milk sauce 2.07.15.284 sour cream sauce 1.95.75.278 cumin 19.814.611.9333 dried dill 2.50.5 6,340

Dairy

milk 3.23.64.864 kefir 3.42.04.751 cream 2.820.03.7205 sour cream 2.820.03.2206 yogurt 2.92.54.153 acidophilus 2.83.23.857 yogurt 4.32.06.260

Meat products

boiled beef 25.816.80.0254 boiled beef tongue 23.915.00.0231 boiled veal 30.70.90.0131 rabbit 21.08.00.0156

Bird

boiled chicken25,27,40,0170turkey19,20,70,084

Eggs

chicken eggs12,710,90,7157

Oils and fats

Peasant unsalted butter 1.072.51.4662 corn oil 0.099.90.0899 olive oil 0.099.80.0898 sunflower oil 0.099.90.0899 ghee 0.299.00.0892

Non-alcoholic drinks

mineral water0,00,00,0-coffee with milk and sugar0,71,011,258black tea with milk and sugar0,70,88,243

Juices and compotes

apricot juice0,90,19,038carrot juice1,10,16,428pumpkin juice0,00,09,038

Fully or partially limited products

Fish, meat and mushroom broths. Alcohol and carbonated drinks. Refractory fats. Products high in salt: chips, salted nuts, canned food, cheeses, sausages, sauces, ketchups, marinades, soups instant cooking, bouillon cubes, salted butter, margarine. Foods high in potassium: coffee, powdered milk, curry, sorrel, bananas, fruit juices, sea fish, meat, seeds, sesame, chocolate, milk formula, dried fruits, dried apples, nuts, marzipan, wine, beer, rhubarb, avocado, fruit juices, tomato juice, peanut butter, ketchup, tomato sauce, spinach, beets, artichoke, molasses, apple syrup, soy, lentils, soy products, mushrooms. Products containing phosphorus: milk, bran, cheese, muesli, whole grain bread, eggs, legumes, cottage cheese, cereals, nuts, cocoa. Milk, eggs, potatoes are limited.

Table of prohibited products

	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
Vegetables and greens
vegetables legumes	9,1	1,6	27,0	168
sauerkraut	1,8	0,1	4,4	19
green onion	1,3	0,0	4,6	19
bulb onions	1,4	0,0	10,4	41
canned cucumbers	2,8	0,0	1,3	16
pickles	0,8	0,1	1,7	11
radish	1,2	0,1	3,4	19
white radish	1,4	0,0	4,1	21
turnip	1,5	0,1	6,2	30
celery	0,9	0,1	2,1	12
canned tomatoes	1,1	0,1	3,5	20
horseradish	3,2	0,4	10,5	56
garlic	6,5	0,5	29,9	143
spinach	2,9	0,3	2,0	22
sorrel	1,5	0,3	2,9	19
Fruits
apricots	0,9	0,1	10,8	41
bananas	1,5	0,2	21,8	95
nectarine	0,9	0,2	11,8	48
peaches	0,9	0,1	11,3	46
Mushrooms
mushrooms	3,5	2,0	2,5	30
marinated mushrooms	2,2	0,4	0,0	20
Cereals and porridges
semolina	10,3	1,0	73,3	328
cereals	11,9	7,2	69,3	366
corn grits	8,3	1,2	75,0	337
pearl barley	9,3	1,1	73,7	320
millet cereal	11,5	3,3	69,3	348
Flour and pasta
pasta	10,4	1,1	69,7	337
Chocolate
chocolate	5,4	35,3	56,5	544
Raw materials and seasonings
mustard	5,7	6,4	22,0	162
ginger	1,8	0,8	15,8	80
ketchup	1,8	1,0	22,2	93
mayonnaise	2,4	67,0	3,9	627
ground black pepper	10,4	3,3	38,7	251
tomato sauce	1,7	7,8	4,5	80
Cheeses and cottage cheese
cottage cheese	17,2	5,0	1,8	121
Meat products
pork	16,0	21,6	0,0	259
salo	2,4	89,0	0,0	797
Bird
smoked chicken	27,5	8,2	0,0	184
duck	16,5	61,2	0,0	346
smoked duck	19,0	28,4	0,0	337
goose	16,1	33,3	0,0	364
Fish and seafood
dried fish	17,5	4,6	0,0	139
smoked fish	26,8	9,9	0,0	196
black caviar	28,0	9,7	0,0	203
salmon caviar granular	32,0	15,0	0,0	263
canned fish	17,5	2,0	0,0	88
Oils and fats
animal fat	0,0	99,7	0,0	897
cooking fat	0,0	99,7	0,0	897
Juices and compotes
tomato juice	1,1	0,2	3,8	21

* data is per 100 g of product

Diet menu for kidney failure (Diet)

The patient's nutrition depends on the level azotemia and disorders of phosphorus-calcium metabolism, and the diet should be agreed only with a doctor. For patients without dialysis, a low-protein diet (0.6 g of protein per kg of body weight) is recommended. Moreover, 50% should be high protein energy value(animal proteins). Low energy proteins are plant proteins that do not contain the full complement of amino acids. For calculations, the patient should use protein replacement units high value, low and potassium and keep a food diary.

Small egg contains 6 g of high value protein

For example, 6 g of high-value protein is contained in: 30 g of fish, 25 g of meat, 1 small egg, 150 ml of yogurt, 60 g of sour cream, 25 g of hard cheese and 25 g of shellfish. Two grams of low value protein contain 150 g of oatmeal with water, 120 g of potatoes, 100 g of rice, 50 g of couscous, 60 g of pasta. 55-60 g of meat or fish once a day are allowed daily.

Potassium units - 200 mg of potassium (or 1 unit) is contained in: 75 g of raw cabbage, carrots, lettuce, pepper, celery and 150 g of boiled cabbage, carrots, celery, beets, onions, beans. To reduce potassium in vegetables, you need to boil them by removing the peel. Cooking in microwave oven does not deprive them of potassium.

On the recommendation of a doctor, you can use specialized low-protein products: artificial sago, salt-free bread made from maize starch, amylopectin starch, protein-free bread. You can eat 300-400 g of this bread per day. To add flavor to unsalted food, dill, parsley, basil, bay leaf, cloves, cinnamon, onion, garlic, and celery are used. Only strict implementation all dietary requirements and counting the number of foods can help overcome the disease.

To reduce symptoms and improve the clinical picture, you should definitely follow a special diet. It can be either low-carbohydrate or low-protein (at the last stage of the disease).

Below we will describe a diet for diabetic nephropathy, present a sample menu, and also talk about the benefits of a low-carbohydrate diet for type 1 and type 2 diabetes mellitus.

This disease is one of the leading causes of death in diabetics. The vast majority of patients on the waiting list for kidney transplants and dialysis are patients with diabetes.

Diabetic nephropathy is a broad concept, including damage to the glomeruli, tubules, or vessels that supply the kidneys. This disease develops due to regular higher level blood glucose.

The danger of such nephropathy for diabetic patients is that the final stage may develop when dialysis is required. In this case, proteins that burden the functioning of the kidneys are completely excluded from the diet.

Symptoms of the disease:

• lethargy;
• metallic taste in the mouth;
• fast fatiguability;
• cramps of the limbs, often in the evening.

Typically, diabetic nephropathy does not manifest itself in any way in the early stages. So, a patient with diabetes is recommended to undergo such tests once or twice a year:

1. urine tests for creatinine, albumin, microalbumin;
2. Ultrasound of the kidneys;
3. blood test for creatinine.

When making a diagnosis, many doctors recommend a low-protein diet, believing that they increase the load on the kidneys. This is partly true, but it was not proteins that caused the development of diabetic nephropathy. It's all to blame high sugar, toxic to kidney function.

To avoid the last stage of kidney disease, you need to eat a properly balanced diet. Such diet therapy will be aimed at the cause of the disease – high blood sugar.

The choice of products when creating a menu should be based on their glycemic index (GI).

Sugar level

A low-carbohydrate diet maintains normal sugar levels in type 2 diabetes, and in type 1 diabetes it significantly reduces the amount of short-acting and ultra-short-acting insulin. It is precisely this property that helps to avoid many complications from diabetes.

The concept of GI is a digital indicator of the intake and breakdown of carbohydrates in the blood that affect blood glucose levels after their consumption. The lower the indicator, the “safer” the food.

The list of low GI foods is quite extensive, which allows you to create a complete diet without losing the taste of the dishes. Low index will be up to 50 units, average from 50 to 70 units, and high over 70 units.

Typically, for type 1 and type 2 diabetes, it is allowed to consume foods with an average index several times a week. But in diabetic nephropathy this is contraindicated.

Diabetic nephropathy diet is formed not only by foods with low GI, but also by methods heat treatment dishes. The following preparation is acceptable:

• steamed;
• boil;
• in the microwave;
• simmer in a small amount of vegetable oil;
• bake;
• in a slow cooker, except for the “fry” mode.

Below is a list of products that make up the diet.

The patient's food should be varied. The daily diet consists of cereals, meat or fish, vegetables, fruits, dairy and fermented milk products. The norm of liquid consumption is two liters.

It is worth knowing that fruit and berry juices are prohibited for dietary nutrition, even those made from low GI fruits. With this treatment, they lose fiber, which serves as a uniform supply of glucose to the blood.

It is better to eat fruits and berries in the morning, no more than 150 - 200 grams. They should not be pureed, so as not to increase the GI. If a fruit salad is prepared from these products, this should be done immediately before consumption in order to preserve as many useful vitamins and microelements as possible.

Low GI fruits and berries:

1. black and red currants;
2. gooseberry;
3. apples of any variety, their sweetness does not affect the index;
4. pear;
5. apricot;
6. blueberry;
7. raspberries;
8. strawberry;
9. strawberries
10. any types of citrus fruits - lemon, orange, tangerine, pomelo, lime.

Vegetables are the basis diabetic nutrition and make up up to half of the total diet. They can be served for breakfast, both, and for afternoon tea and dinner. It is better to choose seasonal vegetables, they contain more useful substances.

Vegetables for diabetic nephropathy with low GI:

• squash;
• onion;
• garlic;
• eggplant;
• tomato;
• green beans;
• lentils;
• all types of cabbage - cauliflower, broccoli, white and red cabbage;
• Bell pepper.

Cereals can be used as side dishes or added to first courses. You should be extremely careful when choosing them, as some have medium and high GI. If you have diabetes that is not complicated by other diseases, doctors allow you to eat occasionally corn porridge– GI in high limits, as it is rich in nutrients. But in diabetic nephropathy, its consumption is contraindicated. Since even a minimal jump in blood sugar puts a strain on the kidneys.

Allowed cereals:

• pearl barley;
• barley grits;
• Brown rice;
• buckwheat.

Their dairy and fermented milk products Almost everyone has a low GI; only the following should be excluded:

1. sour cream;
2. cream 20% fat;
3. sweet and fruity yogurt;
4. butter;
5. margarine;
6. hard cheeses (low index, but high calorie content);
7. condensed milk;
8. glazed curd;
9. curd mass (not to be confused with cottage cheese).

Eggs are allowed for diabetics no more than one per day, since the yolk contains harmful cholesterol. With this nephropathy, it is better to reduce the consumption of such a product to a minimum.

This does not apply to proteins; their GI is 0 units, and the yolk index is 50 units.

Meat and fish should be chosen from low-fat varieties, removing any remaining skin and fat from them. Caviar and milk are prohibited. Meat and fish dishes consist of daily diet, preferably once a day.

The following meats and offal are allowed:

• chicken;
• quail;
• turkey;
• rabbit meat;
• veal;
• beef;
• beef liver;
• chicken liver;
• beef tongue.

From fish you can choose from:

1. pollock;
2. pike;
3. cod;
4. perch.

By forming a diabetic diet for a patient from products of all the above categories, a person receives proper and healthy food.

It aims to maintain blood sugar levels within a normal range.

The menu presented below can be changed according to a person's taste preferences. The main thing is that the products have a low GI and are properly thermally processed. It is forbidden to add too much salt to food; it is better to reduce salt consumption to a minimum.

Avoid starvation and overeating. These two factors provoke spikes in blood sugar. Eat small meals, five to six times a day.

If you feel very hungry, you are allowed to have a light snack, for example, a small portion of vegetable salad or a glass of fermented milk product.

Monday:

• second breakfast - an omelet of proteins and vegetables, green tea with a slice of rye bread;
• lunch – vegetable soup, barley with fish cutlet, green coffee with cream;
• afternoon snack – vegetable salad, tea;
• first dinner - sweet peppers stuffed with minced chicken with brown rice, tea;

1. first breakfast – one apple, cottage cheese;
2. second breakfast vegetable stew for type 2 diabetics, for example, eggplant, tomato, onion and sweet pepper, green tea;
3. lunch – buckwheat soup, steamed barley porridge meat cutlet, green coffee with cream;
4. afternoon snack – jelly with oatmeal, a slice of rye bread;
5. dinner - meatballs, vegetable salad.

• first breakfast - fruit salad seasoned with kefir;
• second breakfast - steamed egg white omelette, coffee with cream;
• lunch – vegetable soup, barley porridge with stewed chicken liver gravy, green tea;
• afternoon snack – 150 ml yogurt;
• first dinner - stewed cabbage with rice and mushrooms, a slice of rye bread;
• second dinner – tea with diabetic cheesecakes.

1. first breakfast - jelly on oatmeal, a slice of rye bread;
2. second breakfast - vegetable salad, boiled egg, green tea;
3. lunch - pearl barley soup, baked eggplants stuffed with minced turkey, tea;
4. afternoon snack – 150 grams of cottage cheese and a handful of dried fruits (dried apricots, prunes, figs);
5. first dinner – buckwheat with boiled beef tongue, tea;
6. second dinner – 150 ml of fermented baked milk.

• first breakfast - fruit salad;
• second breakfast – vegetable salad, a slice of rye bread;
• lunch – vegetable soup, stewed mushrooms with chicken fillet, green coffee with cream;
• afternoon snack – 150 grams of cottage cheese, dried fruits, tea;
• first dinner - pearl barley, steamed fish cutlet, green tea;
• second dinner - a glass of low-fat kefir.

1. first breakfast - green coffee with cream, three pieces of diabetic fructose cookies;
2. second breakfast – steam omelette with vegetables, green tea;
3. lunch - soup with brown rice, stewed beans with veal, a slice of rye bread, tea;
4. afternoon snack – jelly with oatmeal, a slice of rye bread;
5. first dinner - perch baked in a sleeve with vegetables, tea;
6. second dinner - half a glass of yogurt.

Sunday:

• first breakfast – tea with cheesecakes;
• second breakfast - an omelet of proteins and vegetables, a slice of rye bread;
• lunch will be pea soup for type 2 diabetics with a slice of rye bread, buckwheat with fish cutlet, green coffee;
• afternoon snack – cottage cheese with dried fruits, tea;
• first dinner - lentils, liver cutlet, green tea;
• second dinner - a glass of yogurt.

The video in this article describes why kidney damage occurs in diabetes.

Sugar level

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The diet for diabetic nephropathy compared to the diet for diabetes mellitus has significant differences. You will have to gradually give up animal proteins, as they complicate the functioning of the kidneys. The diet should predominate dietary products, rich in iron, folic acid, vitamins B and C.

Diabetic nephropathy is a complex concept. It includes a group of kidney diseases that develop due to constant fluctuations in blood sugar levels. One of the manifestations of diabetic nephropathy is chronic renal failure.

In diabetic nephropathy, the diet is aimed at normalizing the patient’s condition and preventing possible complications. If you compare diets for diabetes and diets for kidney nephropathy, the basic principles will be identical:

• Balanced composition. In diabetes mellitus, both at the initial stage and in chronic form will have to give up the majority familiar products. These are smoked meats, marinades, alcohol, spices, salt, sweets, flour. Such a refusal leads to nutritional deficiencies, so you need to replenish them through proper nutrition. When does diabetes become chronic stage, many destructive processes occur in the body. One of them is impaired renal function. The latter leads to the leaching of necessary micro- and macroelements from the body. Special nutrition including foods such as pomegranate, beets, grapes, and cabbage will help make up for losses.
• Small portions. If you have diabetes, it is important to avoid overeating. In this case, the load on the digestive organs sharply increases, and this is fraught with sharp jump blood sugar levels. In addition, in the chronic form of diabetes, the production of enzymes secreted by the digestive organs is disrupted. It leads to stagnation, diarrhea, bloating, nausea, belching, flatulence. If you reduce portion sizes to 250-300 g (about the size of a fist), the stomach and intestines will experience less stress.
• Minimum sugar. No comments needed - minimum dose sugar can lead to sharp deterioration patient's condition. Therefore, in addition to preparing diet food, it is also important to monitor your sugar levels on an empty stomach, two hours after meals and before bed.
• Refusal of salt. Both sugar and salt retain water in the body. This is why most diabetics suffer from edema. Maximum permissible quantity salt per day – 3 g.
• Eating foods with a low glycemic index (GI) is an indicator of the speed at which carbohydrates contained in a food product are absorbed by the body and increase blood sugar levels.

List of low GI foods		Nuances of use
Berries and fruits	black and red currants; gooseberries, apples, pears, apricots; blueberries, raspberries, strawberries; strawberry, lemon, orange, tangerine, pomelo, lime	Those who suffer from gastritis need to be careful with citrus fruits. peptic ulcer, colitis. 1 fruit per day is allowed
Vegetables	squash, onions, garlic; eggplant, tomato, green beans; lentils, carrots, beets; fresh and dried split peas; all types of cabbage - cauliflower, broccoli, white and red cabbage, sweet peppers	Onion and garlic are contraindicated for gastritis and ulcers. Cabbage can cause bloating and flatulence, so no more than 300 g per day is recommended. Be careful with zucchini, carrots, and beets for nephropathy, as they are diuretics (this is an extra burden on the kidneys)
Cereals	pearl barley; barley grits; Brown rice; buckwheat, bulgur	You can eat 1 plate of bulgur per day (no more than 100 g of dry product), as it is very high in calories (345-360 g per 100 g of product)
Dairy	sour cream, cream 20% fat; sweet and fruit yogurt, butter, margarine, hard cheeses; condensed milk, glazed cheese, curd mass	You can eat no more than 30 g of hard cheese per day due to its high calorie content. Sour cream and butter - no more than a tablespoon per day, preferably in the form of dressing or sauce

Eating meat for diabetes and diabetic nephropathy has significant differences. If diabetics are recommended to eat dietary lean meat (chicken, turkey, rabbit, veal), then in case of nephropathy, even this will gradually have to be abandoned. Otherwise, the kidneys may fail altogether.

Nutritionist's comment! With diabetic nephropathy, the structure of the kidneys changes - the tubules and glomeruli increase in size due to proliferation connective tissue. Because of this, the outflow of blood is disrupted, so that the ability to filter it and remove toxins is sharply deteriorated. The more animal protein products a person consumes, the more the load on the kidneys increases. Nitrogen compounds, the end products of protein breakdown, enter through the blood. If you don't take timely measures and switch to food lists that contain plant protein (such as legumes), you may need dialysis in the near future. This hardware method blood purification, which, like the kidneys, allows you to filter metabolic products and remove them from the body

The maximum allowable amount of protein per day is 70 g.

Another fundamental difference between the diet for patients with diabetes and patients with diabetic nephropathy. Amount of fluid per day. In the first case, the minimum amount of liquid per day is 1.5-2 liters. This is what allows you to maintain water-salt balance.

In diabetic nephropathy, the amount of fluid is reduced by about half to minimize the load on the kidneys. Both the product list and maximum amount fluids per day are determined by the attending physician.

When eating vegetables, fruits and berries, avoid those that contain oxalic acid. Celery, spinach, sorrel, parsley, and rhubarb are allowed in microscopic doses. And also apricots, pineapples, bananas, zucchini, peaches, parsley. This also includes tomatoes, black currants, radishes, dill, beans, horseradish, spinach and potatoes. If you eat them, then in the form of a salad or as part of a soup.

Diabetic nephropathy affects not only structural units kidneys (nephrons), but also the blood vessels adjacent to them. Cholesterol accumulates in the latter, causing the walls of blood vessels to become thinner and, consequently, their permeability to protein structures increases. And also because destructive changes kidneys, blood pressure increases. One of the primary goals of the diet is to stabilize the amount of cholesterol and normalize blood pressure.

Nutritional features and food combinations depend on the stage of the disease. At the initial stage, you need to reduce the amount of carbohydrates to avoid spikes in blood sugar levels.

If the disease has reached a chronic stage, first of all, reduce the amount of animal protein. Ideally, it is completely abandoned, replaced with vegetable - no more than 70 g per day. The next step is fluid restriction (up to 1 liter per day). Refusal of diuretic products (cucumbers, zucchini, watermelon, celery, parsley). All this is in order to prevent the proliferation of connective tissue in the kidneys, reduce the level of intoxication, reduce the load on the kidneys and delay the appointment of dialysis.

Recipes for cooking dishes for nephropathy can be found in the video below.

Diabetic nephropathy is a renal pathology in which damage to the tissues of the organ and its vessels occurs; it often develops as a complication of diabetes mellitus. For treatment, medications and a special diet are prescribed for diabetic kidney nephropathy, which helps reduce the load on the urinary system and the severity of the symptomatic picture.

The choice of diet for nephropathy is made by the attending physician, based on the data obtained during the examination. The way of eating during the acute period of the disease helps to cope with severe swelling of the body and normalize the water-salt balance. Thanks to this, the severity of signs of intoxication in the body is reduced and the diuretic function is normalized. The choice of dietary table is made with the aim of reducing the amount of harmful compounds that can come from food.

Depending on the severity of symptoms, the cause of the pathological process, as well as general condition patient, dietary table 7, 7a, 7b is prescribed.

All areas of nutrition are based on general principles:

• reducing the amount of fatty foods and animal protein, which are gradually replaced by vegetable fats;
• reducing the amount of salt consumed per kilogram of weight;
• refusal of canned, fried, smoked, salted, spicy and pickled foods;
• plenty of drinking regime;
• fractional meals with frequent appointments food in small portions;
• exclusion of light carbohydrates and sugar;
• with an increased concentration of potassium in the blood - a decrease in its intake from food;
• if potassium levels are low, ensure sufficient intake from food;
• reducing the amount of food high in phosphorus;
• eating foods that contain large amounts of iron;
• all products are consumed boiled or cooked on a steam grill;
• Dietary nutrition for children is similar to that for adults.

During the period of illness of paired organs, their performance is impaired, which manifests itself in a decrease in the removal of waste and toxins from the body. The most difficult for the kidneys are nitrogenous compounds, which are formed from protein products of animal origin. Therefore, all diets renal pathologies aimed at gradually reducing the daily amount of animal protein consumed and replacing it with protein plant origin.

It's important to remember that abrupt refusal Protein products injure a weakened body and can lead to a worsening of the condition. Therefore, this process must be gradual. It is recommended to replace first fatty foods dietary (chicken, low-fat fish, veal).

A large amount of salt in the daily diet leads to the formation of swelling and an increase in intrarenal and blood pressure. Therefore, to reduce the severity of these symptoms, gradual salt restriction is necessary.

It is recommended to cook food without salt or, if necessary, add a little salt before eating. To improve the taste characteristics of food, salt can be replaced with tomato juice without salt, lemon juice, garlic, onions, and herbs.

Malfunctions of the kidneys lead to disruption of the process of potassium excretion in the body, which is responsible for the performance of paired organs, the heart muscle and muscle tissue. Therefore, its excess or deficiency can lead to irreversible consequences in organism. Doctors recommend increasing daily potassium intake in the initial stages of nephropathy, and reducing it in later stages.

Excessive phosphorus content in human blood leads to gradual leaching of calcium from the body, to the development of aching joints and gradual thinning of bone and cartilage tissue. Phosphorus also causes tissue hardening, resulting in rapid growth of connective tissue in the kidneys, heart muscle, joints and lungs. Therefore, renal pathology is manifested by itchy dermatoses, impaired heart rate and a feeling of heaviness in the lungs. In the acute period, it is necessary to strictly limit the intake of this element, which will help speed up the recovery process.

Sufficient intake of clean drinking water into the body - important condition proper diet. Water helps cleanse the body of harmful compounds, which has a positive effect on the dynamics of recovery. To ensure good urine passage, during treatment it is necessary to avoid spicy, fatty, salty and canned foods, which retain fluid in the body and lead to contamination and increased swelling.

During the period of renal pathologies and chronic renal failure, the menu should include foods rich in iron, zinc, calcium and selenium. During the course of the disease, impaired metabolism leads to a lack of nutrients that are necessary for normal performance organs and systems.

Diet for diabetic nephropathy No. 7 is recommended for restoring metabolic processes, reducing swelling, intrarenal and blood pressure. Used for diabetic and dismetabolic nephropathy, glomerulonephritis, chronic renal failure and other renal pathologies.

According to the table's recommendations, restrictions include foods high in carbohydrates and fats. Dishes are prepared without salt. The daily volume of fluid consumed is no more than 1 liter. Daily calorie content products - no more than 2900 kcal, including carbohydrates - up to 450 g, proteins - up to 80 g, fats - up to 100 g, sugar - up to 90 g.

During diet No. 7 you are allowed to consume:

• vegetable broth soups;
• lean meats and tongue;
• lean fish;
• dairy products, except cheese;
• porridge;
• vegetables;
• fruits;
• eggs no more than 2 pcs.;
• honey, jam, jelly;
• bread and pancakes without salt.

It is prohibited to use:

• salted flour products;
• fatty meat and fish products and broths based on them;
• mushrooms;
• hard and soft cheese;
• legumes;
• products with a high proportion of oxalic and ascorbic acids;
• chocolate.

Prescribed for nephropathy, chronic renal failure, glomerulonephritis in order to reduce the load on diseased paired organs, normalize metabolic processes and reduce the severity of symptoms (edema, high blood pressure).

Proteins and salt are subject to restrictions, fats and carbohydrates are slightly reduced. Preference is given to products of plant origin. Daily consumption protein - no more than 20 g, half of which is of animal origin. The volume of fat should not exceed 80 g, carbohydrates 350, of which 1/3 is sugar. Daily water consumption is calculated based on the daily volume of urine excreted, plus 0.5 liters.

List of products allowed for consumption:

• bakery products without salt;
• vegetable soups;
• lean meats and fish;
• dairy products (consumption of cottage cheese is allowed with the complete exclusion of meat products);
• eggs, no more than 2 pcs. in Week;
• fruits;
• vegetables;
• protein-free pasta, sago, rice;
• vegetable and animal oils;
• sugar, honey, jam, sweets, jelly;
• herbal infusions, teas, compotes.

List of prohibited products:

• salted flour products;
• meat and fish of fatty varieties;
• mushrooms;
• hard cheese;
• legumes;
• cereals;
• chocolate;
• coffee, cocoa;
• spices, mustard, horseradish.

The recommendations of table No. 7b are aimed at restoring metabolism, blood pressure in blood vessels, relieving swelling. It is used for kidney pathologies after dietary table No. 7a. Proteins and salt are prohibited; fats and carbohydrates are not strictly limited. Diet No. 7b is one of the most gentle.

Daily protein intake should be within 60 g, of which 60% is of animal origin. Fats - up to 90 g, of which 20 g are of vegetable origin. The daily amount of carbohydrates is no more than 450 g, sugar consumption is allowed up to 100 g. Salt is prohibited. Drinking regime- up to 1.5 l.

The list of permitted and prohibited foods is similar to dietary table No. 7a.

Diet - effective therapeutic method for kidney diseases of various etiologies. Helps reduce the load on diseased organs and the severity of the clinical picture. Helps normalize metabolic processes and urination. Used for treatment dietary tables No. 7, 7a and 7b.

The term nephropathy combines various pathological processes occurring in the kidneys. Diet for kidney nephropathy is an important component for maintaining health. Such nutrition is aimed at normalizing metabolic processes in the body. Except therapeutic nutrition, it is necessary to eliminate the accompanying symptoms and stop the disease that caused the development of nephropathy.

The provocateurs of the problem are:

• diabetes;
• pregnancy;
• gout;
• low hemoglobin;
• heredity;
• poisoning with chemicals or drugs;
• hormonal changes;
• metabolic disorders;
• infectious diseases of the urinary tract;
• stones in the kidneys.

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The diet is compiled after a complete examination of the patient in order to determine the individual needs and characteristics of the patient. In the first stages of the disease, it is enough to include small dietary restrictions for prevention purposes. In advanced cases, nutrition should be therapeutic. With the help of proper nutrition, the water-salt balance in the body is restored. Thanks to specially selected products, the urinary system begins to function normally, and as a result, swelling of the limbs decreases or completely disappears. Blood pressure resumes and the body becomes intoxicated.

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More about proteins

Reducing daily protein intake, required component complex treatment sick.

Damaged kidneys have difficulty removing nitrogenous waste; most of it is produced by proteins of animal origin. However, a sudden refusal of animal products is stressful for the body, which further worsens the state of health. You should gradually reduce your daily protein intake. It is recommended to switch to dietary meat, fish, and then completely to protein of plant origin.

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More about salt

If edema or high blood pressure develops, it is necessary to reduce salt intake. During cooking, do not add salt at all; add a little salt to the food before eating. Go to salt-free diet occurs gradually to adapt taste sensations. Salt improves the taste of food, so it is important when switching to a salt-free diet to start consuming other products that improve the taste of food: tomato juice or sauce without salt, lemon juice, dried herbs, dried garlic and onions, celery stalk salt.

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Depending on the results of the analysis, it is worth increasing or decreasing the amount of foods containing potassium in the diet. Usually when early manifestations disease, it is necessary to increase potassium intake, and in later cases, on the contrary, limit it. Bananas, many nuts, cottage cheese, buckwheat, spinach, avocado, and oatmeal are rich in potassium. If there is a need to reduce potassium in the product, heat treatment is used.

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A gradual decrease in phosphorus in the diet has a positive effect on treatment, slowing down the growth of connective tissue in the kidneys and the appearance of chronic or acute intoxication. Spicy, fatty, canned and pickled foods put a lot of stress on the urinary system. Water must be consumed in sufficient quantities; in the morning, drinking water starts all processes in the body and cleanses the body of toxins that have accumulated overnight. However, with rapid weight gain due to edema, it is necessary to reduce fluid intake while the cause is eliminated.

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During the period of illness and treatment, the human body is deprived of many useful substances. Therefore it is necessary to take vitamin supplements, including trace elements of iron, zinc, selenium, calcium. Include iron-rich foods in your diet: grapes, beets, pomegranate. It will be very important in your diet to increase cholesterol-lowering foods: cabbage of various varieties, greens, green wheat sprouts. In addition, refusal fast carbohydrates lowers cholesterol and insulin levels in the blood.

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Meat dishes

Vegetarian and vegan vegetable dishes with or without cereals are favorable. Meat, mushroom dishes, eggs are unfavorable. When switching to vegetable protein, fish soups and broths are allowed. Prohibited are sausages, canned meat, salted and smoked fish. It is important to completely eliminate dairy products.

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All whole grain cereals are good, especially gluten-free ones: millet (millet), buckwheat, amaranth, quinoa, chia, brown rice, all legumes are good. It is necessary to refuse white rice, oatmeal, instant cereals are especially harmful. Gluten grains are undesirable: corn, wheat, barley, oatmeal. Durum wheat pasta is allowed. You can eat whole grain, yeast-free bread or crispbread. All baked goods with sugar, yeast, and baked from white and black refined flour are prohibited.

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Almost all vegetables are beneficial: potatoes, beets, carrots, white cabbage, Brussels sprouts, broccoli, cauliflower, pumpkin, green peas, zucchini, sweet peppers, eggplant, tomatoes, cucumbers, greens. You must be careful when consuming radishes, radishes, sorrel, spinach, garlic and fresh onions. Canned and pickled vegetables are prohibited.

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In the first half, it is favorable to consume natural sweets: fruits, berries, dried fruits, honey. However, if the disease is infectious, you should also avoid them. You should completely exclude chocolate, muesli, condensed milk, sweets, cakes, cookies, any desserts and confectionery products with sugar, diabetic products with sugar substitute.

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Dried herbs, garlic, onions, soft spices are beneficial: cardamom, coriander, fennel, turmeric, asafoetida. Good sauces with added lemon juice based on crushed pumpkin and sunflower seeds. Homemade tomato sauce is good. Horseradish, mustard, mayonnaise, ketchup, soy sauce, milk sauce, chili pepper, ginger, and black pepper are prohibited.

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good herbal teas, rosehip decoction, drinks with lemon, green smoothies based on water and green wheat sprouts, green vegetable juices, pure water. It is necessary to exclude black and green tea, coffee, cocoa, alcoholic drinks, milk, juices, water rich in sodium, carbonated drinks. Barley drinks and chicory are allowed.

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Raw and soaked sunflower seeds, pumpkin seeds, almonds, and cashews are beneficial. Flax and chia seeds are very good. Unrefined, cold-pressed oils are allowed; they are best used olive oil. Should be taken with caution Walnut, Brazilian, peanuts, macadamia. Ghee, butter, fish and animal fat, and lard are prohibited.

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After waking up, drink 1 liter of water with a small amount of fresh lemon juice. After 15 minutes, drink a green smoothie made with water, green wheat sprouts and lemon or eat fruit. An hour after fruit, it is beneficial to eat a vegetable salad. Use fresh, seasonal vegetables. Add your choice of pumpkin, sunflower or flax seeds to the salad, season vegetable oil. From 12:00 to 15:00 digestion is strongest, so it’s good if lunch occurs at this time. Lunch should be complete and light at the same time. Be sure to include fresh salad dishes, stewed vegetables and cooked grains or legumes. You can eat whole grain, yeast-free bread. It is prohibited to wash down lunch with any liquid. 2 hours after eating, take a decoction of immunomodulating herbs. For dinner, it is beneficial to eat cooked and fresh vegetables.

Diabetic nephropathy is a renal pathology in which damage to the tissues of the organ and its vessels occurs; it often develops as a complication of diabetes mellitus. For treatment, medications and a special diet are prescribed for diabetic kidney nephropathy, which helps reduce the load on the urinary system and the severity of the symptomatic picture.

The choice of diet for nephropathy is made by the attending physician, based on the data obtained during the examination. The way of eating during the acute period of the disease helps to cope with severe swelling of the body and normalize the water-salt balance. Thanks to this, the severity of signs of intoxication in the body is reduced and the diuretic function is normalized. The choice of dietary table is made with the aim of reducing the amount of harmful compounds that can come from food.

Depending on the severity of symptoms, the cause of the pathological process, as well as the general condition of the patient, dietary table 7, 7a, 7b is prescribed.

All areas of nutrition are based on general principles:

• reducing the amount of fatty foods and animal protein, which are gradually replaced by vegetable fats;
• reducing the amount of salt consumed per kilogram of weight;
• refusal of canned, fried, smoked, salted, spicy and pickled foods;
• plenty of drinking regime;
• fractional meals with frequent meals in small portions;
• exclusion of light carbohydrates and sugar;
• with an increased concentration of potassium in the blood - a decrease in its intake from food;
• if potassium levels are low, ensure sufficient intake from food;
• reducing the amount of food high in phosphorus;
• eating foods that contain large amounts of iron;
• all products are consumed boiled or steamed/grilled;
• Dietary nutrition for children is similar to that for adults.

Read more about nutrition components

During the period of illness of paired organs, their performance is impaired, which manifests itself in a decrease in the removal of waste and toxins from the body. The most difficult for the kidneys are nitrogenous compounds, which are formed from protein products of animal origin. Therefore, all diets for renal pathologies are aimed at gradually reducing the daily amount of animal protein consumed and replacing it with protein of plant origin.

It is important to remember that a sudden refusal of protein foods traumatizes a weakened body and can lead to a worsening of the condition. Therefore, this process must be gradual. It is recommended to first replace fatty foods with dietary ones (chicken, low-fat fish, veal).

A large amount of salt in the daily diet leads to the formation of swelling and an increase in intrarenal and blood pressure. Therefore, to reduce the severity of these symptoms, gradual salt restriction is necessary.

It is recommended to cook food without salt or, if necessary, add a little salt before eating. To improve the taste characteristics of food, salt can be replaced with tomato juice without salt, lemon juice, garlic, onions, and herbs.

The effect of nutrition on kidney function

Malfunctions of the kidneys lead to disruption of the process of potassium excretion in the body, which is responsible for the performance of paired organs, the heart muscle and muscle tissue. Therefore, its excess or deficiency can lead to irreversible consequences in the body. Doctors recommend increasing daily potassium intake in the initial stages of nephropathy, and reducing it in later stages.

Excessive phosphorus content in human blood leads to the gradual leaching of calcium from the body, to the development of aching joints and the gradual thinning of bone and cartilage tissue. Phosphorus also causes tissue hardening, resulting in rapid growth of connective tissue in the kidneys, heart muscle, joints and lungs. Therefore, renal pathology is manifested by itchy dermatoses, heart rhythm disturbances and a feeling of heaviness in the lungs. In the acute period, it is necessary to strictly limit the intake of this element, which will help speed up the recovery process.

Sufficient intake of clean drinking water into the body is an important condition for a proper diet. Water helps cleanse the body of harmful compounds, which has a positive effect on the dynamics of recovery. To ensure good urine passage, during treatment it is necessary to avoid spicy, fatty, salty and canned foods, which retain fluid in the body and lead to contamination and increased swelling.

During the period of renal pathologies and chronic renal failure, the menu should include foods rich in iron, zinc, calcium and selenium. During the course of the disease, impaired metabolism leads to a lack of nutrients that are necessary for the normal functioning of organs and systems.

Dietary table No. 7

Diet for diabetic nephropathy No. 7 is recommended for restoring metabolic processes, reducing swelling, intrarenal and blood pressure. Used for diabetic and dismetabolic nephropathy, glomerulonephritis, chronic renal failure and other renal pathologies.

According to the table's recommendations, restrictions include foods high in carbohydrates and fats. Dishes are prepared without salt. The daily volume of fluid consumed is no more than 1 liter. The daily calorie content of foods is no more than 2900 kcal, including carbohydrates - up to 450 g, proteins - up to 80 g, fats - up to 100 g, sugar - up to 90 g.

During diet No. 7 you are allowed to consume:

• vegetable broth soups;
• lean meats and tongue;
• lean fish;
• dairy products, except cheese;
• porridge;
• vegetables;
• fruits;
• eggs no more than 2 pcs.;
• honey, jam, jelly;
• bread and pancakes without salt.

It is prohibited to use:

• salted flour products;
• fatty meat and fish products and broths based on them;
• mushrooms;
• hard and soft cheese;
• legumes;
• products with a high proportion of oxalic and ascorbic acids;
• chocolate.

Dietary table No. 7a

Prescribed for nephropathy, chronic renal failure, glomerulonephritis in order to reduce the load on diseased paired organs, normalize metabolic processes and reduce the severity of symptoms (edema, high blood pressure).

Proteins and salt are subject to restrictions, fats and carbohydrates are slightly reduced. Preference is given to products of plant origin. Daily protein intake is no more than 20 g, half of which is of animal origin. The volume of fat should not exceed 80 g, carbohydrates 350, of which 1/3 is sugar. Daily water consumption is calculated based on the daily volume of urine excreted, plus 0.5 liters.

List of products allowed for consumption:

• baked goods without salt;
• vegetable soups;
• lean meats and fish;
• dairy products (consumption of cottage cheese is allowed with the complete exclusion of meat products);
• eggs, no more than 2 pcs. in Week;
• fruits;
• vegetables;
• protein-free pasta, sago, rice;
• vegetable and animal oils;
• sugar, honey, jam, sweets, jelly;
• herbal infusions, teas, compotes.

List of prohibited products:

• salted flour products;
• meat and fish of fatty varieties;
• mushrooms;
• hard cheese;
• legumes;
• cereals;
• chocolate;
• coffee, cocoa;
• spices, mustard, horseradish.

Dietary table No. 7b

The recommendations of table No. 7b are aimed at restoring metabolism, blood pressure in the vessels, and relieving swelling. It is used for kidney pathologies after dietary table No. 7a. Proteins and salt are prohibited; fats and carbohydrates are not strictly limited. Diet No. 7b is one of the most gentle.

Daily protein intake should be within 60 g, of which 60% is of animal origin. Fats - up to 90 g, of which 20 g are of vegetable origin. The daily amount of carbohydrates is no more than 450 g, sugar consumption is allowed up to 100 g. Salt is prohibited. Drinking regime - up to 1.5 l.

The list of permitted and prohibited foods is similar to dietary table No. 7a.

Diet is an effective therapeutic method for kidney diseases of various etiologies. Helps reduce the load on diseased organs and the severity of the clinical picture. Helps normalize metabolic processes and urination. For treatment, dietary tables No. 7, 7a and 7b are used.

Similarities between diet for diabetes and diabetic nephropathy

Diabetic nephropathy is a complex concept. It includes a group of kidney diseases that develop due to constant fluctuations in blood sugar levels. One of the manifestations of diabetic nephropathy is chronic renal failure.

In diabetic nephropathy, the diet is aimed at normalizing the patient’s condition and preventing possible complications. If you compare diets for diabetes and diets for kidney nephropathy, the basic principles will be identical:

• Balanced composition. With diabetes, both at the initial stage and in the chronic form, you will have to give up most of your usual foods. These are smoked meats, marinades, alcohol, spices, salt, sweets, flour. Such a refusal leads to nutritional deficiencies, so you need to replenish them through proper nutrition. When diabetes mellitus becomes chronic, many destructive processes occur in the body. One of them is impaired renal function. The latter leads to the leaching of necessary micro- and macroelements from the body. Special nutrition including foods such as pomegranate, beets, grapes, and cabbage will help make up for losses.
• Small portions. If you have diabetes, it is important to avoid overeating. In this case, the load on the digestive organs sharply increases, and this is fraught with a sharp jump in blood sugar levels. In addition, in the chronic form of diabetes, the production of enzymes secreted by the digestive organs is disrupted. This leads to congestion, diarrhea, bloating, nausea, belching, and flatulence. If you reduce portion sizes to 250-300 g (about the size of a fist), the stomach and intestines will experience less stress.
• Minimum sugar. Comments are unnecessary - a minimal dose of sugar can lead to a sharp deterioration in the patient’s condition. Therefore, in addition to preparing diet food, it is also important to monitor your sugar levels on an empty stomach, two hours after meals and before bed.
• Refusal of salt. Both sugar and salt retain water in the body. This is why most diabetics suffer from edema. The maximum allowable amount of salt per day is 3 g.
• Eating foods with a low glycemic index (GI) is an indicator of the speed at which carbohydrates contained in a food product are absorbed by the body and increase blood sugar levels.

List of low GI foods		Nuances of use
Berries and fruits	black and red currants; gooseberries, apples, pears, apricots; blueberries, raspberries, strawberries; strawberry, lemon, orange, tangerine, pomelo, lime	Those who suffer from gastritis, peptic ulcers, and colitis need to be careful with citrus fruits. 1 fruit per day is allowed
Vegetables	squash, onions, garlic; eggplant, tomato, green beans; lentils, carrots, beets; fresh and dried split peas; all types of cabbage - cauliflower, broccoli, white and red cabbage, sweet peppers	Onions and garlic are contraindicated for gastritis and ulcers. Cabbage can cause bloating and flatulence, so no more than 300 g per day is recommended. Be careful with zucchini, carrots, and beets for nephropathy, as they are diuretics (this is an extra burden on the kidneys)
Cereals	pearl barley; barley grits; Brown rice; buckwheat, bulgur	You can eat 1 plate of bulgur per day (no more than 100 g of dry product), as it is very high in calories (345-360 g per 100 g of product)
Dairy	sour cream, cream 20% fat; sweet and fruit yogurt, butter, margarine, hard cheeses; condensed milk, glazed cheese, curd mass	You can eat no more than 30 g of hard cheese per day due to its high calorie content. Sour cream and butter - no more than a tablespoon per day, preferably in the form of dressing or sauce

Differences in nutrition between diabetes and diabetic nephropathy

Eating meat for diabetes and diabetic nephropathy has significant differences. If diabetics are recommended to eat dietary lean meat (chicken, turkey, rabbit, veal), then in case of nephropathy, even this will gradually have to be abandoned. Otherwise, the kidneys may fail altogether.

Nutritionist's comment! With diabetic nephropathy, the structure of the kidneys changes - the tubes and glomeruli increase in size due to the proliferation of connective tissue. Because of this, the outflow of blood is disrupted, so that the ability to filter it and remove toxins is sharply deteriorated. The more animal protein products a person consumes, the more the load on the kidneys increases. Nitrogen compounds, the end products of protein breakdown, enter through the blood. If you don't take timely measures and switch to food lists that contain plant protein (such as legumes), you may need dialysis in the near future. This is a hardware method of blood purification, which, like the kidneys, allows you to filter metabolic products and remove them from the body

The maximum allowable amount of protein per day is 70 g.

Another fundamental difference between the diet for patients with diabetes and patients with diabetic nephropathy. Amount of fluid per day. In the first case, the minimum amount of liquid per day is 1.5-2 liters. This is what allows you to maintain water-salt balance.

In diabetic nephropathy, the amount of fluid is reduced by about half to minimize the load on the kidneys. Both the list of products and the maximum amount of liquid per day are determined by the attending physician.

When eating vegetables, fruits and berries, avoid those that contain oxalic acid. Celery, spinach, sorrel, parsley, and rhubarb are allowed in microscopic doses. And also apricots, pineapples, bananas, zucchini, peaches, parsley. This also includes tomatoes, black currants, radishes, dill, beans, horseradish, spinach and potatoes. If you eat them, then in the form of a salad or as part of a soup.

Nutrition goals for diabetic nephropathy

In diabetic nephropathy, not only the structural units of the kidneys (nephrons) are affected, but also the blood vessels adjacent to them. Cholesterol accumulates in the latter, causing the walls of blood vessels to become thinner and, consequently, their permeability to protein structures increases. And due to destructive changes in the kidneys, blood pressure increases. One of the primary goals of the diet is to stabilize the amount of cholesterol and normalize blood pressure.

Nutritional features and food combinations depend on the stage of the disease. At the initial stage, you need to reduce the amount of carbohydrates to avoid spikes in blood sugar levels.

If the disease has reached a chronic stage, first of all, reduce the amount of animal protein. Ideally, it is completely abandoned, replaced with vegetable - no more than 70 g per day. The next step is fluid restriction (up to 1 liter per day). Refusal of diuretic products (cucumbers, zucchini, watermelon, celery, parsley). All this is in order to prevent the proliferation of connective tissue in the kidneys, reduce the level of intoxication, reduce the load on the kidneys and delay the appointment of dialysis.

Sample menu for the day

Breakfast (one of the dishes)	Lunch (one of the dishes)	Dinner (one of the dishes)
Fruit salad (can be seasoned with kefir)	Vegetable soup, barley with fish cutlet, green coffee	Peppers stuffed with bulgur and tomatoes, dried fruit compote
Omelette of egg whites and sweet peppers, green tea with a slice of rye bread	Barley or buckwheat soup, bulgur or lentil porridge with steamed chicken cutlet, cranberry juice	Chicken meatball, sweet pepper, carrot, cucumber and tomato salad
Green apple, cottage cheese with a tablespoon of sour cream	Vegetable soup, barley porridge with stewed chicken liver gravy, green tea	Braised cabbage with rice and mushrooms, a slice of rye bread
Vegetable stew of eggplant, tomato, onion and sweet pepper, green tea	Chicken bouillon, lentil porridge with stewed chicken liver gravy, green tea	Buckwheat with hake fillet baked in foil, tea

Recipes for cooking dishes for nephropathy can be found in the video below.