Uremia and Hemodialysis: Am I Overloading on Protein?

In the sweltering summer, are kidney patients on long-term dialysis fretting over their daily meals? Do you understand how dialysis impacts your nutritional status?

Diet and Nutrition in Hemodialysis
Reports from China indicate that about 77% of dialysis patients suffer from varying degrees of malnutrition, with the prevalence increasing as dialysis duration extends.
Evaluations from dialysis centers in several European and American countries reveal that 6–8% of patients experience severe malnutrition, while 33% face mild to moderate malnutrition.
This highlights the need to foster a proper understanding of “diet and nutrition.” Balanced, scientific eating empowers our organs, tissues, and systems to combat disease with full strength!

Some kidney patients, upon learning of nutrient deficiencies, remain dismissive or overly optimistic. Here, Teacher Xiao Cui warns that malnutrition poses significant risks, such as triggering complications like myocardial infarction or heart failure. For kidneys already functioning poorly, malnutrition exacerbates the burden, markedly increasing mortality rates.

Moreover, as the saying goes, “Only good food and love should never be betrayed.” Dialysis patients already endure immense physical and psychological stress. Now, more than ever, we should learn to eat healthily and joyfully.

This article begins with a focus on “high-quality protein”:

1. Why Is Adequate Protein Intake Essential?
In the non-dialysis stage, a “low-protein diet” is advised. Impaired kidney function hinders toxin clearance, so reducing protein intake minimizes metabolic waste like urea and creatinine, easing the kidneys’ load.
However, once dialysis begins, the body’s detoxification support improves, but each session results in a loss of 10–30g of protein. Thus, patients should increase protein intake appropriately to maintain nitrogen balance and prevent malnutrition.

2. The “Right Amount” and “High Quality” of Protein
Quantity: Aim for 1.2g/(kg·day), with at least 50% being high-quality protein. For example, a 50kg patient needs 50 × 1.2 = 60g of total protein daily, of which 60 × 50% = 30g should be high-quality protein.
Be sure to account for protein from staples, fruits, and vegetables!
Quality: “Good protein” primarily comes from animal sources, rich in essential amino acids and producing fewer metabolic wastes. Examples include eggs, fish, lean meat, and fresh milk. “Poor protein,” mainly from plant sources like rice, noodles, beans, vegetables, and fruits, is less ideal.

3. What If I’m Still Hungry After Eating?
If the calculated portion leaves you hungry, opt for low-protein starches to supplement, but avoid mindlessly gobbling down steamed buns or rice until overstuffed!
Low-protein starches include wheat starch, corn starch, red potato starch, and similar options.

4. What If I’m Vegetarian?
Vegetarians need not worry excessively. Based on blood levels of calcium, phosphorus, and potassium, you can incorporate beans, soy products, and mushrooms, which provide protein to partially meet the nutritional needs of dialysis patients.