The main principles of the diet for chronic kidney disease. What can you eat if you have kidney failure? Therapeutic nutrition for renal failure

At acute renal failure Protein is sharply limited, up to 20 g per day, and calories are provided from carbohydrates and fats.

Sources of animal protein are milk, cream, fermented milk drinks, sour cream, eggs; carbohydrates – vegetables, fruits, berries, sugar, honey, sago, rice; fats – butter and vegetable oils.

Depending on the patient’s condition, fluid is given from 400–500 ml per day and more (if there is vomiting, diarrhea and other factors of fluid loss). The patient is given water, weak tea with lemon, juices diluted with water, kefir, etc. Insufficient or excessive fluid intake can aggravate kidney dysfunction.

Limit foods containing a lot of potassium and magnesium, and in the presence of oligo- or anuria (little or no urine output) - sodium. Therefore, vegetables and fruits are used mainly after cooking, draining the broth. During the recovery period of diuresis (3–4 weeks), urine output can exceed 2 liters per day (polyuria), which leads to depletion of the body in fluids and minerals (potassium, sodium, etc. are excreted). Therefore, the patient is allowed increased fluid intake in the form of tea with lemon, undiluted juices, rosehip decoction or dried fruits, etc. Table salt is gradually introduced into the diet, and the protein content in it is increased first to 40 g, and then to the physiological norm (1 g per 1 kg body weight).

Nutrition during this period is based on diet No. 7B, and subsequently - diet No. 7, which should be followed during the period of long-term (from 3 to 12 months) recovery. In case of mild acute renal failure, you can immediately use diet No. 7B with a restriction of potassium in it. For diets, see Appendix.

The main principles of the diet for chronic renal failure: varying degrees of protein restriction depending on the severity of the disease, providing the body with fats and carbohydrates, regulating salt and fluid intake.

The menu is compiled within table No. 7 (see Appendix). The daily diet includes the following products: meat (100–120 g), cottage cheese dishes, cereal dishes, semolina, rice, buckwheat, pearl barley porridge. Particularly suitable due to their low protein content and at the same time high energy value are potato dishes (pancakes, cutlets, babkas, fried potatoes, mashed potatoes, etc.), salads with sour cream, vinaigrettes with a significant amount (50-100 g) of vegetable oil. Tea or coffee can be acidified with lemon, put 2-3 tablespoons of sugar per glass, it is recommended to use honey, jam, jam. Thus, the main composition of food is carbohydrates and fats (with the exception of refractory ones - lamb, pork, beef) and in doses - proteins. Calculating the daily amount of protein in the diet is mandatory. When compiling a menu, you should use tables reflecting the protein content of the product and its energy value.

Be sure to include fruits and juices in your diet, because a person needs vitamins, and there are also a lot of light carbohydrates.

All dishes are prepared without salt. However, in the early stages of chronic renal failure, you can lightly add salt to ready-made dishes on the table at the rate of no more than 5–6 g of salt per day under control of pressure and the possibility of edema formation.

Meat (lean beef, veal, chicken, turkey, rabbit) and fish are used boiled or then fried. At the same time, extractive substances that irritate kidney tissue are prohibited, that is, no broths (except vegetable ones) are used.

Vegetables used include potatoes, beets, carrots, cauliflower, lettuce, tomatoes, fresh cucumbers, green onions, dill, and parsley.

Eggs in their pure form are consumed in the form of a protein omelet (no more than one per day).

Fruits and berries in raw and boiled form (compotes), sweets: honey, sugar, jam, sweets, and, on the recommendation of a doctor, dried apricots and apricots are useful.

With chronic renal failure, appetite usually decreases, and taste may be distorted; this should be kept in mind when preparing dishes. Moreover, you cannot salt the dishes. To improve the taste, use sour and sweet and sour sauces, food acids (citric, vinegar), spices, and spicy vegetables. You can use onions to a limited extent.

In the initial stage of chronic renal failure, the amount of protein in the diet is limited slightly (up to 70 g, or 1 g of protein per 1 kg of body weight). It is recommended to consume mainly proteins of plant origin, which are found in bread, vegetables, fruits, and nuts (see table).

The amount of fluid in the early stages of chronic renal failure is also not particularly limited. However, it should not exceed the amount of urine excreted over the previous day by more than 500 ml. In addition to soups, you can drink diluted vegetable and fruit juices or hydrocarbonate mineral waters (Borjomi, Luzhanskaya No. 1).

Once a week it is advisable to have a fasting day (pumpkin, watermelon, potato, apple).

At an advanced stage of chronic renal failure the amount of protein is sharply limited (up to 20–40 g per day). The main part of the proteins (70–75%) should be proteins of animal origin (milk, eggs, meat, fish) to provide the body with essential amino acids.

It should be remembered that a low-protein diet eases the load on diseased kidneys, but only if the diet is high in calories, since with a lack of calories, the metabolism changes! Not only your own fats, but also proteins begin to “burn”, the urea level rises and the meaning of a low-protein diet is nullified. Therefore, a patient with chronic renal failure should receive at least 2500–3000 kcal from food, while consuming no more than 25–30 g of protein.

Foods and drinks that irritate the kidneys are prohibited: strong coffee, tea, cocoa, chocolate, spicy and salty snacks, meat broths, fish and mushroom decoctions, alcohol.

The number of meals is 5–6 times a day.

In advanced stages of chronic renal failure, hemodialysis is performed using an “artificial kidney” device - purification of the blood from metabolic products of proteins and other substances. With chronic hemodialysis, patients may develop some complications due to an unbalanced diet, since this removes amino acids from the body. You need to replenish your amino acid content by adjusting your diet.

In patients with chronic renal failure on hemodialysis protein intake should be 0.75-1 g of protein per 1 kg of body weight per day. When the hemodialysis time is increased to 30 hours per week, the amount of protein is increased to 1.2 g per 1 kg of body weight.

Food is prepared without salt. If blood pressure is low and there is no swelling, the patient is given 2–3 g of salt so that he can add salt to food if desired. Due to repeated hemodialysis, the amount of potassium, calcium and phosphorus in the body may increase, so in this case, limit the consumption of vegetables and fruits, as well as dairy products, legumes, cabbage and mushrooms. Fruits such as apricots, raisins, prunes, bananas, dried fruits are completely excluded from the diet.

The amount of liquid is limited to 700–800 ml per day. You are allowed to drink a small amount of fruit juices (lemon, apple, cherry, tomato).

After boiling, meat and fish can be fried to add flavor. Spices and herbs that do not irritate the kidneys are added to dishes: dill, bay leaf, cinnamon, cloves, allspice, parsley, vanillin. Irritating seasonings are prohibited: horseradish, garlic, radish, mustard.

Food is taken 6 times a day, in small portions.

In addition to the products mentioned, black currants, melons, peaches, rhubarb, celery, and chicory are also limited. Spicy and salty dishes, meat broths, fish and mushroom broths, canned snack foods, sausages, smoked meats, and chocolate are prohibited.

Recipes can also be used from the chapters “Pyelonephritis” and “Glomerulonephritis”.

Recipes for acute renal failure

Fresh cabbage soup

Ingredients: cabbage – 200 g, turnip – 1 pc., carrots – 1 pc., fresh herbs, leeks, tomato 1 pc., bay leaf.

Cut turnips, carrots, parsley, leeks into slices or cubes, fry a little, and then simmer in a frying pan in a small amount of water. Chop the cabbage, place in boiling water, bring to a boil, add a bunch of fresh herbs and cook for another 30–40 minutes. 5-10 minutes before the end of cooking, season with stewed root vegetables and add bay leaf. If cabbage soup is prepared with fresh tomatoes, then cut them into slices and place them in the pan at the same time as the vegetables.

Mixed vegetable soup

Ingredients: water or vegetable (not mushroom!) broth – 500 ml, onion – 1 pc., carrots – 1 pc., cabbage – 250 g, potatoes – 2 pcs., tomato – 1 pc., boiled beef -100 g per portion, herbs, spices to taste.

Place potatoes, carrots and shredded cabbage into the boiling broth. Shortly before the vegetables are ready, add lightly boiled and then fried onions, green onions, and tomato slices. Serve with boiled beef and chopped fresh herbs.

Eggplant soup

Ingredients: water or vegetable broth – 500 ml, eggplant – 1 pc., carrots – 1 pc., onion – 1 pc., bell pepper – 1 pc., potatoes – 2 pcs., herbs and spices to taste.

Cut a medium-sized eggplant into slices and lightly fry in butter, rolling in flour. Fry finely chopped carrots and bell peppers, then add water and simmer. Throw potatoes and onions into boiling water, and when they are cooked, add eggplants and carrots with bell peppers. After the soup is ready, let it steep a little, then it becomes tastier.

Potato soup with sago

Ingredients: potatoes – 5 pcs., carrots – 2 pcs., parsley root, onion – 1 pc., butter – 3 tbsp. l., sago - 0.5 cups, bay leaf, dill, parsley.

Place peeled and sliced ​​potatoes into a boiling vegetable broth, let it boil and cook for 5 minutes, add sago and cook for 5-7 minutes. Lightly fry the diced carrots, parsley and onions in butter, then pour in a little water and simmer, then pour everything into the soup, let it simmer for 2-3 minutes and move the pan to the edge of the stove. Add bay leaf and let it brew. When serving, sprinkle with finely chopped parsley and dill.

Beetroot

Ingredients: beet broth – 500 ml, beets – 1 pc., fresh cucumber – 1 pc., potatoes – 2 pcs., egg – 1 pc., green onion, herbs, sour cream, citric acid.

Boil the peeled beets (can be cut into several parts), cool the broth. Chop green onions, dill, parsley, beets, cucumbers, boiled potatoes. Season with sour cream and citric acid.

Fruit okroshka

Ingredients: fruit infusion – 500 ml, apple – 1 pc., melon – 100 g, peaches – 5 pcs., cherries 1 glass, lettuce, sour cream.

Peel the apple, melon, cut them into cubes. Scald and peel the peaches and chop the pulp. Wash the cherries and remove the pits. Tear the salad with your hands. Grind cherries, fruit peels, pour boiling water and leave for 1.5–2 hours. Pour the infusion over the cooked fruits. Serve with sour cream.

Peppers stuffed with carrots

Ingredients: peppers – 4 pcs., carrots – 3 pcs., onions – 3 pcs., tomatoes – 3 pcs., vegetable oil – 3 tbsp. l., bay leaf, parsley and dill.

Remove the seeds from the peppers, rinse and stuff with carrots, previously stewed with onions. Place the prepared peppers in a saucepan, add water, add chopped tomatoes, bay leaves and simmer until tender.

Stuffed zucchini

Ingredients: zucchini – 1 medium, for minced meat: boiled rice – 1 glass, egg – 1 pc., carrots – 1 pc.... onion – 1 pc., sour cream – 100 ml.

Cut the zucchini into thick slices, remove the core and peel. Prepare minced meat from a mixture of rice, boiled and then fried onions, carrots and eggs and fill the zucchini, place on a baking sheet, pour in sour cream. Bake in the oven until done.

Pumpkin stewed with dill

Ingredients: pumpkin – 1 medium, onion – 3 pcs., dill, sour cream, lemon juice.

Pour water (2 cups) into sliced ​​peeled pumpkin along with finely chopped onions and simmer over low heat until smooth. 5 minutes before readiness, add chopped dill. Before serving, top with sour cream. You can add lemon juice.

Soaked carrot pudding

Ingredients: carrots – 2 pcs., butter – 15 g, sour cream – 2 tbsp. l., milk – 50 ml, cottage cheese 50 g, egg – 1 pc., sugar to taste.

Grate the peeled carrots on a fine grater, pour in 2 liters of cold water and soak for 3-4 hours, changing the water every hour. Then squeeze the carrots through cheesecloth, pour in milk, add 2/3 of the oil and simmer. Add the yolk mixed with grated cottage cheese, as well as whipped egg white and sugar to the prepared carrots, mix everything, put it in a greased mold and bake. Serve with sour cream.

Beetroot with apples

Beets – 5 pcs., apple – 2 pcs., sour cream 100 ml, citric acid to taste.

Peel the young beets and grate them on a coarse grater. Then put it in a saucepan, add a small amount of hot water and simmer until half cooked over low heat. Add grated apples, sour cream and simmer until done. At the end add citric acid. Boil.

Eggplant baked with curdled milk

Ingredients: eggplants – 4 pcs., tomatoes – 5-6 pcs., egg – 2 pcs., curdled milk – 1 glass, butter – 50 g.

Wash the eggplants, cut crosswise into slices 1 cm thick, add salt, leave for 10–15 minutes, then rinse in cold water, pat dry with a napkin and fry in oil on both sides. Place the eggplants in a deep frying pan, layering them with sliced ​​tomatoes. Beat eggs with curdled milk, pour mixture over eggplants and bake.

Boiled meat and cottage cheese cutlets

Ingredients: beef – 200 g, egg – 1 pc., cottage cheese – 100 g, butter.

Boil the meat until almost fully cooked. Pass through a meat grinder 2 times along with cottage cheese. Add the egg, beat and cut into cutlets. Bake them in the oven. Serve with a vegetable side dish.

Steamed boiled chicken cutlets

Ingredients: chicken fillet – 200 g, potatoes – 1 pc., milk – 50 ml, butter – 30 g, egg – 1 pc.

Pass the pulp of the boiled chicken through a meat grinder, mix with grated potatoes (the juice from the potato mass can be squeezed out if there is a lot of it). Add oil and mix well. Form cutlets and bake in the oven.

Stuffed cabbage rolls with minced chicken

Ingredients: white cabbage – 800 g, chicken fillet – 300 g, tomatoes – 5 pcs., sour cream 2 tbsp. l., vegetable oil - 100 ml, rice 150 g.

Pass the boiled chicken fillet through a meat grinder. Boil the rice, cool and mix with minced chicken. Remove the cabbage leaves from the head, cook them in boiling water for 3–5 minutes, remove from the water, and cool. Place minced meat on each cabbage leaf and wrap it in the form of sausages or envelopes. Place in a saucepan, add broth from cabbage leaves, add chopped tomatoes and simmer for 30–40 minutes. Serve with sour cream.

Tomatoes stuffed with meat

Ingredients: tomatoes - 2 pcs., veal - 100 g, egg - 1 pc., green onions, dill, green pepper, sour cream - 50 g, mayonnaise - 2 tbsp. l.

Chop the white of a hard-boiled egg, and finely chop the green onions and peppers. Cut the boiled veal into small cubes and mix with chopped products, herbs and half of the sauce made from mayonnaise mixed with sour cream. After this, cut off the tops of the tomatoes, remove the cores, chop finely and add to the minced meat, which is used to fill the tomatoes.

Before serving, pour the remaining sauce over the tomatoes and sprinkle with chopped herbs.

Zucchini with meat

Ingredients: zucchini – 500 g, boiled chicken breast – 150 g, rice – 70 g, tomatoes – 2 pcs., onions – 2 pcs., sour cream – 70 g, vegetable oil, dill.

Peel the zucchini and cut into rings 1.5–2 cm thick. Make a hole in the middle and add heaping minced chicken breast mixed with boiled rice. Place on a baking sheet, having previously greased it with vegetable oil. For the sauce, simmer the tomatoes and onions, add sour cream. Pour this sauce over the zucchini and bake in the oven.

Meat casserole

Ingredients: potatoes – 5 pcs., meat – 300 g, onions – 2 pcs., egg – 2 pcs., milk – 150 ml, parsley and dill.

Boil the potatoes, mash them, add a little potato broth and eggs. Boil the meat, pass through a meat grinder and mix with boiled and then fried onions. Place a layer of potatoes on a baking sheet greased with vegetable oil, and minced meat on it. Pour in eggs beaten with milk and bake in the oven for 10 minutes at +200 °C. Sprinkle with herbs before serving.

Fish stewed with milk and carrots

Ingredients: fish fillet – 800 g, carrots – 2 pcs., onions – 2 pcs., milk – 500 ml.

Boil the fish fillet until almost done, cut into portions, place in a deep frying pan, add boiled and then fried onion in vegetable oil and carrots cut into round slices. Pour milk, simmer covered for 15 minutes.

Cod stewed in vegetables

Ingredients: cod – 200 g, carrots – 1 pc., onion – 1 pc., tomato – 1 pc., sour cream – 2 tbsp. l., water – 100 ml.

Boil the prepared cod carcass, cut into pieces and place in a frying pan with vegetable oil. Cover with grated carrots, finely chopped onions, herbs, and fresh tomatoes cut into slices. Pour boiled water. Close the lid and simmer for 10 minutes. Season with sour cream, simmer for another 5-10 minutes under the lid.

Fish fillet with apples

Ingredients: boiled fish fillet - 500 g, apples - 3-4 pcs., celery - 30 g, onion - 1 pc., egg white - 3 pcs., milk - 1/2 cup.

Grate apples, onions and celery on a coarse grater, mix and place on the bottom of a mold previously greased with vegetable oil. Separate the egg white, beat it with milk; Place the fish fillet on a fruit and vegetable bed and pour the mixture over it. Bake in the oven.

White omelette

Ingredients: egg (white) – 3 pcs., milk – 4 tbsp. l., butter - 1 tbsp. l., sour cream - 1 tbsp. l.

Mix the whites with milk, beat in a mixer or with a whisk, pour into a greased frying pan, sprinkle with sour cream and bake in the oven.

Omelette with greens

Ingredients: egg – 3 pcs., milk – 1/2 cup, parsley and dill, vegetable oil.

Shake eggs with milk, add chopped parsley and dill. Pour the mixture into the frying pan and fry until done.

Sour cream sauce with tomato juice

Ingredients: sour cream -100 g, egg yolk - 2 pcs., tomato - 1 large (100 g).

Cut the ripe tomato in half and, lightly squeezing the juice out of it, rub through a sieve; Add sour cream to the pureed mass, evaporate the resulting mass by 1/3, combine with raw yolks and, stirring quickly, bring to thickening.

Cold green sauce

Ingredients: parsley and dill – 100 g, egg – 2 pcs., table vinegar – 1 tbsp. l., any vegetable oil - 3 tbsp. l.

Finely chop the greens. Boil the eggs, mash the yolks with a fork, and chop the whites; mix eggs with herbs, add vinegar and vegetable oil. The sauce should have a thick consistency.

Jerusalem artichoke pancakes with carrots

Ingredients: Jerusalem artichoke – 500 g, carrots – 500 g, egg – 2 pcs., corn starch.

Grate Jerusalem artichoke and carrots on a fine grater, add eggs, corn starch, mix everything. Spoon the mixture onto a baking sheet and bake in the oven.

Cranberry jelly

Ingredients: cranberries – 200 g, water – 500 ml, sugar, gelatin – 25 g.

Squeeze the juice from the berries, pour boiling water over the juice and boil. Strain the broth, add sugar and swollen gelatin, let the syrup boil, then cool and strain again. Mix with squeezed fresh juice and pour into molds.

Lemon jelly

Ingredients: lemon – 100 g, gelatin – 15 g, sugar – to taste, water – 650 ml.

Bring the water to a boil, add lemon zest and leave covered for 10-15 minutes, then strain. Place gelatin soaked in cold water into the hot infusion, let it dissolve, then add lemon juice and sugar, strain, pour into a mold and cool. Place the mold with the cooled jelly in hot water for a second and place the jelly on a saucer.

Recipes for chronic renal failure

You can use recipes for dishes from the previous section, as well as the chapters “Pyelonephritis” and “Glomerulonephritis”, many dishes from the section “Diet for oxalate stones” in the chapter “Kidney stones”.

Carrot and apple salad

Ingredients: carrots – 1 pc., apple – 1 pc., mayonnaise – 1 tbsp. l., parsley.

Grate the peeled carrots and apples on a coarse grater, add parsley, mix and season with mayonnaise.

Parsley and apple salad

Ingredients: parsley root – 100 g, apple – 1 pc., sour cream – 2 tbsp. l., lemon juice.

Grate parsley root, mix with finely chopped apple, season with sour cream, add lemon juice.

Summer vinaigrette

Ingredients: potatoes – 2 pcs., carrots – 1 pc., beets – 1 small, cauliflower – 1 head, fresh cucumber – 1 pc., tomato – 2 pcs., lettuce – 1 bunch, egg – 1 pc., sour cream – 100 ml, sugar – 1 tsp, dill.

Boil potatoes, beets, carrots, cauliflower and cool. Peel carrots, beets, potatoes, fresh cucumbers and cut into thin slices, divide cauliflower into small pieces, cut tomatoes into small slices, chop lettuce, chop dill. Place the prepared vegetables in a bowl, add sugar, sour cream and mix well (instead of sour cream, the vinaigrette can be seasoned with vegetable oil with the addition of citric acid or mayonnaise). You can add raw zucchini (young), pumpkin, apples, etc. to the vinaigrette.

Beet and apple salad

Ingredients: beets – 1 small, apple – 1 pc., dill, parsley, sour cream – 1 tbsp. l., salt, citric acid to taste.

Cut the boiled beets into strips, and the apple into cubes, mix, season with citric acid and sour cream. Sprinkle with herbs.

Beet tops salad

Ingredients: beet tops – 100 g, green salad – 30 g, parsley, dill, vegetable oil – 1 tbsp. l., egg – 1 pc.

Finely chop beet tops, green salad, a little dill and parsley, add sunflower oil and finely chopped boiled egg.

Cauliflower salad

Ingredients: cauliflower - 150 g, vegetable oil - 1 tbsp. l., boiled egg - 1 pc., greens, green onions.

Boil the cauliflower, separate it into florets, and pour in vegetable oil. Add greens, sprinkle egg on top.

Kohlrabi and apple salad

Ingredients: kohlrabi cabbage – 150 g, apple – 1 pc., sour cream or vegetable oil – 1 tbsp. l., greens.

Finely chop the peeled kohlrabi cabbage and peeled apples, add parsley, vegetable oil, mix and serve immediately.

Appetizer of white cabbage, cucumbers and carrots

Ingredients: white cabbage – 200 g, cucumber – 3 pcs., carrots – 2 pcs., green salad – 1 bunch, mayonnaise – 100 ml, green onions – 1 bunch.

Wash the cabbage and cucumbers and chop finely. Peel the carrots and grate on a coarse grater. Wash and chop the green onions. Wash the lettuce leaves and cover the dish with them. Mix cabbage with cucumbers, carrots and green onions, stir, season with mayonnaise, place on lettuce leaves and serve.

Semolina soup

Ingredients: semolina – 2 tbsp. l., butter – 1 tsp. without top, water - 2 glasses, granulated sugar.

Dilute the sifted semolina with cold water and pour, stirring continuously, into hot water. Boil, stirring constantly, for about 30 minutes. Then sweeten the soup a little.

Before serving, add fresh butter to the soup.

Semolina milk soup with yolk

Ingredients: semolina – 2 tbsp. l., milk - 2 cups, 2 yolks, granulated sugar - 1 tsp, butter - 1 tsp. without top, water - 1 glass.

Dilute the sifted cereal with cold water, add hot water and boil until fully cooked (30 minutes). Pour milk with diluted yolk and sugar into the boiled mixture. Add butter to the soup.

Soup “Tender”

Ingredients: young curdled milk – 400 ml, ground peanuts – 50 g, fresh cucumbers – 3 pcs., chopped mint leaves – 2 tbsp. l., green onions - 1 bunch, dill.

Finely chop the cucumbers and place them in a saucepan, add yogurt, chopped mint, dill and finely chopped green onions. Mix everything thoroughly and let the soup cool for an hour. When serving, sprinkle each serving of soup with chopped peanuts.

Potato soup

Ingredients: potatoes – 5 pcs., water – 2 l, milk – 1 glass; for dumplings: egg – 1 pc., milk – 100 ml, flour – 1.5 cups.

Peel the potatoes and boil them in water. Drain the water (but do not pour it out), mash the potatoes, pour hot milk into it, mix thoroughly, add the potato broth, mix well again and put on low heat until it boils.

Prepare the dumpling dough: beat the egg with milk, add flour, the dough should not be too liquid and not too stiff, so that when you take it with a spoon, it does not spread, but retains its shape. Take the dough a little at a time, using a teaspoon dipped in cold water, and throw the dumplings into the boiling broth so that they set immediately. Boil covered for 8-10 minutes. When serving, sprinkle with herbs.

Cream of pearl barley soup

Ingredients: pearl barley – 50 g, milk – 1/2 cup, water – 1 cup, butter – 1 tsp. l., egg – 1 pc.

Rinse the pearl barley well, add cold water and cook until softened. Then salt the cereal and rub it hot through a sieve. Prepare the dressing: grind the yolk with 1 tbsp. l. milk and, continuing to grind, pour in the rest of the milk in small portions. Heat the dressing until it boils and gradually, 1 spoon at a time, stirring, add the pureed cereal. Heat the saucepan with soup in a water bath for 10–15 minutes. Add butter to the finished soup.

Puree buckwheat soup

Ingredients: buckwheat – 2 tbsp. l., butter – 1 tsp., milk – 1 glass, water – 2 glasses, egg – 1 pc., olive oil – 1 tsp.

Sort the grains, rinse in running water, add to boiling water and cook until fully cooked. Then rub through a sieve. Place the resulting slurry on the stove, bring to a boil, then set the pan on the edge of the stove. Mix the egg thoroughly, add hot milk and combine with boiling broth; add olive oil, stir. Before serving, add butter to the soup.

Soup "Volynsky"

Ingredients: milk – 2 l, water – 1 glass, carrots – 1 pc., potatoes – 3 pcs., barley – 0.5 cups, sugar – 1 tsp.

Boil barley groats along with potatoes and finely chopped carrots in milk, slightly diluted with water, adding a pinch of sugar.

Cabbage soup with apples

Ingredients: cabbage – 300 g, carrots – 1 pc., rutabaga – 1 pc., parsley root – 1 pc., apple – 1 pc., unsalted tomato paste – 1 tbsp. l., butter – 2 tbsp. l., sour cream.

Place cabbage cut into squares and roots, onions and tomato paste stewed with butter into boiling broth or water. Cook in a sealed container at low boil until done. Add chopped apple to the prepared cabbage soup and boil. Place sour cream on a plate with cabbage soup.

Vegetable broth with egg white omelette

Ingredients: potatoes - 2 pcs., carrots - 1 pc., parsley root, cabbage stalk - 1 pc., parsley, egg white - 1 pc., milk 10 ml, sour cream - 20 ml, butter - 5 g.

Cut the vegetables into pieces and cook under the lid, let it brew for an hour and strain. Mix the egg white with milk, pour into a greased frying pan and bake, then cool to room temperature and cut the omelette into 5-6 pieces. Season the broth with sour cream and the remaining oil, add an omelette and chopped herbs.

Borscht with vegetable broth

Ingredients: white cabbage - 300 g, beets - 1 pc., potatoes - 4 pcs., carrots - 1 pc., tomato - 1 pc., parsley, butter, sour cream, citric acid - to taste (instead of acid you can put apples or black currants).

Chop the peeled beets into strips, sprinkle with citric acid diluted in water and mix; then add oil and 100 ml of water, close the lid and simmer over low heat for 20-30 minutes, then add chopped carrots, celery, part of the tomato and simmer for another 10 minutes. Add shredded cabbage to the prepared vegetables, add water or vegetable broth, let it boil, add chopped potatoes and cook until tender. Place the remaining tomatoes, cut into slices, into the prepared borscht. Before serving, season with sour cream and sprinkle with chopped herbs.

Vegetable puff soup

Ingredients: sunflower oil – 200 ml, onion – 1 pc., tomatoes – 6 pcs., cabbage – half a head of cabbage, sweet pepper – 4 pcs., potatoes – 4 pcs., zucchini – 2 pcs., carrots – 1 pc., Bay leaf.

Pour sunflower oil into the bottom of the goose bowl, put boiled onion rings on the bottom, and put 3 chopped tomatoes on top. Do not mix the layer. The next layer is shredded fresh cabbage. Then - sweet peppers, peeled and cut into rings, on top - chopped potatoes and then diced zucchini and the last layer - 3 chopped tomatoes and grated carrots. Place on low heat; When the vegetables are stewed in oil until tender, add hot water, turn up the heat and bring to a boil.

Without stirring, carefully place the puff pastry into plates, pour in vegetable broth, add sour cream, sprinkle with chopped herbs.

Brussels sprout soup

Ingredients: Brussels sprouts – 600 g, potatoes – 3–4 pcs., vegetable oil, sour cream.

Place the peeled Brussels sprouts in boiling water for 2 minutes, then drain in a colander, drain, transfer the cabbage to a soup pot with melted butter and lightly fry.

Pour 6-7 cups of hot water over the cabbage, add thinly sliced ​​potatoes and cook over low heat for 20-30 minutes. When serving, add sour cream to the soup.

Cauliflower soup

Ingredients: cauliflower – 600 g or white cabbage – 750 g, potatoes – 7 pcs., oil – 3 tbsp. l., milk - 2 cups.

Select a quarter of the small cauliflower stalks for garnish and cook them separately. Place the rest of the cabbage, as well as peeled and washed potatoes, cut into slices, into a saucepan, add four glasses of water and cook for 25–30 minutes. Rub all this through a sieve and dilute with hot milk. When serving, season the soup with cream or butter, stir and add boiled cabbage stalks. Serve the croutons separately.

Puree soup can also be prepared from white cabbage. It must be cleaned, washed and boiled; After 15–20 minutes, add the potatoes, boil them and then prepare the soup as indicated above.

Cream soup in Flemish style

Ingredients: Brussels sprouts puree – 300 g, potato puree – 300 g, vegetable broth or potato or cabbage broth – 1 l, cream 100 ml, egg – 2 pcs., butter – 50 g.

Combine Brussels sprouts and mashed potatoes and dilute with broth. Season with cream and egg yolks, add butter, heat well, but do not boil.

Cauliflower soup with rice

Ingredients: cauliflower -100 g, potatoes - 2 pcs., rice - 20 g, milk - 100 ml, butter - 10 g, water - 500 g.

Cut the potatoes and cabbage into pieces, add water (300 g), and then add half the oil. Bring until cooked over low heat, covered, and rub through a sieve along with the liquid. Place the washed rice in boiling water (200 g) and cook for an hour, then puree, combine with soup, warm well and season with milk.

Before serving, add the remaining butter in a lump.

Peasant soup with cereals

Ingredients: fresh cabbage – 200 g, potatoes – 1 pc., cereals (pearl barley, rice, oatmeal, barley, wheat) – 40 g or millet, oat flakes – 35 g, turnip – 1 pc., carrots – 1 pc., parsley root, onion – 1 pc., tomato – 1 pc., vegetable oil, water – 800 ml, sour cream.

Cook well-washed pearl barley, barley, oatmeal and wheat until half cooked, then put it in boiling water, add cabbage, cut into checkers, potatoes and cook until tender. 15 minutes before the end of cooking, add pre-fried vegetables and tomatoes.

Rice and millet groats are added to the soup along with vegetables, having previously been washed in water; Hercules oat flakes are added 15–20 minutes before the end of cooking the soup.

Serve with sour cream.

Cauliflower broth

Ingredients: chopped cauliflower – 2 cups, water – 1.5 l, potatoes – 2 pcs. medium size, onion – 1 pc., sour cream – 3 tbsp. l.

Finely chop the cabbage inflorescences, cut the leaves into strips, and grate the stalk on a coarse grater. Peel the potatoes and cut into slices, the onion into half rings. Place the vegetables in a saucepan, add hot water, bring to a boil, cook for 5-6 minutes and leave for 5-10 minutes. Add sour cream to the finished stew.

Milk soup with vegetables and pasta

Ingredients: milk – 700 ml, water – 100 ml, carrots – 1 pc., turnip – 1 pc., potatoes – 1 pc., white cabbage – 100 g, celery – 10 g, leek – 2 stems, lettuce – 20 g, pasta – 20 g, butter – 10 g.

Cut the roots and potatoes into slices, cut the cabbage into small pieces, chop the onion, finely chop the lettuce. Boil cabbage for 3-5 minutes. Place vegetables in hot water and cook for 20–30 minutes at low boil. Boil pasta separately. 3-5 minutes before the vegetables are ready, add the pasta and salad.

Boil the milk separately. When serving, place vegetables, butter and milk on a plate.

Milk soup with cauliflower

Ingredients: cauliflower – 1 head with leaves, onion – 1 pc., sweet pepper – 1 pc., potatoes – 2 pcs., carrots – 1 pc., milk – 1 l, water – 1 l, mayonnaise – 1 tbsp. l.

Cut the peeled potatoes into cubes, grate the carrots on a coarse grater, finely chop the cauliflower inflorescence and leaves, cut the pepper into strips. Pour water over the vegetables, bring to a boil, cook for 5-6 minutes, add milk, bring to a boil, remove from heat and leave for 8-10 minutes without heating. When serving, season with mayonnaise.

Mashed potatoes and cabbage

Ingredients: onion – 1 pc., cabbage – 500 g, potatoes – 1 kg.

Place shredded cabbage in a frying pan, pour boiling water and simmer. After 10 minutes, add the chopped onion and simmer until soft. Add boiled, crushed potatoes, beat everything.

Cauliflower puree

Ingredients: cauliflower – 300 g, butter or vegetable oil – 1 tsp, milk – 50 ml.

Peel the cauliflower, remove the green leaves, cut into small pieces and rinse thoroughly. Then pour in a small amount of boiling water, close the lid and simmer over low heat until cooked and the water has completely boiled away. When hot, rub through a sieve, add hot milk and boil again for 1-2 minutes. Add butter or vegetable oil to the finished puree.

Cauliflower with mashed potatoes

Ingredients: cauliflower – 200 g, potatoes – 3 pcs., butter – 2 tbsp. l., milk - 1 cup.

Boil the cauliflower, drain in a colander and let drain. Wipe and mix with mashed potatoes. Dilute the resulting puree with hot milk and heat on the stove for 2-3 minutes, whisking continuously. Do not bring to a boil.

When serving, add butter to the puree.

Buckwheat porridge pureed

Ingredients: buckwheat – 1 tbsp. l., milk – 1.5 cups, water – 150 ml, sugar syrup – 10 ml, butter – 1 tsp.

Pour pre-sorted and washed buckwheat into boiling water while stirring. Cover with a lid and cook over low heat until done. Rub the boiled porridge through a sieve, add hot milk, sugar syrup and, stirring, boil for 2-3 minutes. Add butter to the prepared porridge.

Buckwheat porridge with cauliflower and milk

Ingredients: cauliflower – 200 G, buckwheat – 1 cup, butter – 2 tbsp. l., milk – 500 ml.

Wash the cauliflower, chop finely and place in a layer on the bottom of the dish. Place washed buckwheat on top, pour in milk, bring everything to a boil, cook for 5–6 minutes, close the pan with a lid, cover with a towel and leave without heating for 10–15 minutes. Serve with butter.

Oatmeal

Ingredients: oatmeal – 3/4 cup, butter – 2 tbsp. l., water - 2 glasses.

Pour water into a small saucepan and bring to a boil, add oatmeal. Cook for 10 minutes. Rub through a sieve. Add oil to the finished porridge.

Millet porridge

Ingredients: millet – 3 tbsp. l., l., butter – 1 tsp.

Sort the millet, rinse thoroughly with warm water several times until the water becomes clear. Pour boiling water over it, drain the water, add a glass of boiling water again and cook until completely softened (until the cereal is rubbed freely between your fingers).

Rub the hot cereal through a hair sieve, dilute with hot milk, add sugar and rub again. Place over low heat and heat for 5 minutes until thickened, stirring constantly. Add butter to the prepared porridge.

Puree rice porridge

Ingredients: rice – 3 tbsp. l., water – 2 glasses, milk – 1 glass, sugar – 2 tsp. l., butter – 1 tsp.

Sort the rice, rinse well, pour a glass of boiling water and cook over low heat until softened. Add water little by little as it boils so that half of the liquid remains in the saucepan.

Press the boiled rice hot through a fine sieve. Pour hot milk into the puree and stir thoroughly until smooth. Add sugar, put it back on the stove and, stirring, let the porridge boil 2-3 times until it thickens. Add butter to the prepared porridge.

Rice pilaf with fruits and vegetables

Ingredients: rice – 100 G, raisins – 30 G, prunes – 50 G, carrots – 1 pc., cauliflower – 100 G, butter – 30 G, water – 200 ml.

Sort the rice, rinse and add to boiling water; adding butter and sugar, bring to a boil and cook until tender in a water bath. Place the finished rice in a frying pan, mix with washed raisins, prunes, stewed carrots and boiled cauliflower, add a little water, cover and simmer for 15 minutes until the flavors mix.

Semolina

Ingredients: milk – 2 glasses, water – 100 ml, semolina – 2 tbsp. l., sugar syrup – 10 ml, butter – 1 tsp.

Pour water into half of the milk, boil, then add semolina in a thin stream and cook over low heat, stirring constantly, for 15–20 minutes. Then add sugar syrup and the remaining heated milk. Bring the porridge to a boil. Add butter to the prepared porridge.

Semolina soufflé

Ingredients: semolina – 2 tbsp. l., water – 1 cup, milk – 1/2 cup, butter – 1 tsp. l., egg – 1 pc., sugar – 2 tsp.

Boil milk diluted with water. Pour semolina into boiling milk and cook for 20 minutes, stirring constantly with a whisk. Remove from heat, add butter, sugar, yolk and white, whipped into a strong foam. Stir everything carefully and place in a greased mold, filling it 3/4 full. Place in the oven (medium heat) for 20 minutes.

Pink semolina porridge

Ingredients: semolina – 2 tbsp. l., milk – 200 ml, water – 1/2 cup, sugar syrup – 2 tbsp. l., carrot juice – 100 ml, butter – 1 tsp.

Pour fresh carrot juice into the prepared, slightly cooled semolina porridge, stir thoroughly and serve immediately.

Preparation of carrot juice: wash the carrots with a brush, scald with boiling water, scrape off the skin with a sharp knife, wash again with boiled water and grate. Place the carrots in gauze scalded with boiling water and squeeze out the juice.

Tzimes Jewish

Ingredients: carrots – 1 pc., turnip – 1 pc., rutabaga – 1 pc., cauliflower – 1 head, onion – 2 pcs., raisins – 100 g, butter – 100 g, sugar or honey, milk – 500 ml .

Cut carrots, turnips, rutabaga, onions, cauliflower into pieces and boil in milk. When everything is ready, add small raisins, a little sugar or honey and butter and simmer under the lid for half an hour, adding flour for thickness.

Cabbage casserole with pasta

Ingredients: white cabbage – 300 g, finely broken pasta or horns – 1 glass, water – 1 glass, egg – 2 pcs., milk 1 glass.

Cut the cabbage into strips, finely chop the stalk, and mix everything. Place half the cabbage on the bottom of the dry form, dry pasta on it, and the remaining cabbage on top. Pour the prepared mixture with hot water, bring to a boil and bake for 15–20 minutes at a temperature of +200–220 °C.

Mix eggs with milk and pour onto the surface of the casserole. Then place back in the oven for 15-20 minutes.

Vegetable casserole

Ingredients: cabbage – 500 g, rutabaga – 1 pc., turnip – 2 pcs., carrots – 2 pcs., prunes – 5 pcs., raisins – half a glass, sugar; for the sauce: flour – 3 tbsp. l., milk – 200 ml.

Chop fresh cabbage, carrots, rutabaga and turnips into small strips, add a little water to them and simmer until tender. Place on a sieve.

Prepare the sauce separately. With continuous stirring, dilute the dried flour with hot milk so that there are no lumps and boil for 10 minutes.

Place the steamed vegetables in a greased frying pan, add washed, pitted prunes and raisins, sprinkle the casserole with sugar and place in the oven to bake. When serving, pour the sauce over the casserole or serve it separately.

Stewed cabbage

Ingredients: cabbage – 400 g, butter – 1 tbsp. l., milk – 1 glass, flour – 1 tbsp. l.

Wash half a small head of fresh cabbage, disassemble into leaves and cut out the stalk. Finely chop the leaves and simmer in milk, half diluted with water. When the cabbage becomes soft, add oil and, stirring, add flour in a thin stream. Stir until smooth, boil for 5-7 minutes and serve.

Cabbage stewed with rice

Ingredients: cabbage – 500 g, rice – 100 g, vegetable oil – 4 tbsp. l., onion – 1 pc., tomato 1 pc., parsley – 1 bunch.

Wash and chop the cabbage. Peel the onion, wash and finely chop. Wash the tomato and rub through a sieve. Wash and chop the parsley. Mix cabbage with onion, place in a saucepan, add water, add rice, add vegetable oil and simmer for 15 minutes over low heat, then add grated tomato and simmer until tender.

Carrots stewed with seaweed and apples

Ingredients: carrots – 2 pcs., seaweed – 100 g, apple – 1 pc., vegetable oil – 50 ml, raisins – 20 g.

Grate the carrots and, adding vegetable oil, simmer over low heat until soft. At the end of the stew, add boiled seaweed, peeled apple cut into slices, and raisins. Simmer over low heat, covered, until the apples soften.

Stuffed cabbage rolls with boiled meat, rice and vegetables

Ingredients: cabbage – 500 g, meat – 200 g, rice – 40 g, carrots – 1 pc., parsley, rutabaga 1 pc., flour – 1 tbsp. l., sour cream – 50 ml, butter – 2 tbsp. l., vegetable broth - 150 ml.

Boil a head of cabbage (without the stalk) until half cooked, separate it into individual leaves and cut off the stem from each leaf. After this, cut the carrots and rutabaga into small cubes and simmer with butter in a small amount of water. Boil the meat, pass through a meat grinder, combine with stewed vegetables, boiled fluffy rice and chopped herbs, mix well and, dividing into 2-3 parts, wrap in cabbage leaves, put in a pan, pour in sour cream sauce and bake.

To prepare sour cream sauce, mix flour with sour cream and pour this mixture into boiling vegetable broth; let it boil for 5 minutes, strain, add a tablespoon of oil and mix well.

Buckwheat cabbage rolls

Ingredients: buckwheat porridge – 300 g, onion – 1 pc., carrots – 1 pc.... tomato sauce – 30 ml, white cabbage leaves, spices to taste.

To fill the cabbage rolls, cook crumbly buckwheat porridge, add onions and carrots stewed in a small amount of water. Knead everything thoroughly, wrap the minced meat in prepared cabbage leaves.

Place the finished cabbage rolls in a duck pan greased with vegetable oil, pour in tomato sauce diluted with water and simmer in the oven until cooked.

Stuffed cabbage rolls with rice and quince

Ingredients: cabbage – 1 head, vegetable oil – 2 tbsp. l.; for minced meat: rice - 1 cup, quince - 1 large fruit, onion - 1 pc., carrots - 1 pc., oil - 2 tbsp. l., chopped dill and parsley - 2 tbsp. l.

Disassemble the cabbage into leaves, place them in boiling water, cook for 20 minutes, drain in a colander and let the water drain. It is necessary to cut off the thickened veins and lightly beat them off. Wash the rice and cook crumbly porridge. Lightly simmer or boil the carrots and onions. Peel the quince from the skin and seeds, cut into small cubes, boil in water until soft, drain the broth into another bowl, and drain the quince in a colander. Combine rice, quince, carrots, onions, season with finely chopped herbs, mix. Place minced meat in the leaves, wrap in envelopes, tie with thread and fry on both sides. Place the cabbage rolls in a saucepan or roasting pan, pour over them with vegetable oil and quince decoction, cover with a lid, put in a heated oven and bring to readiness.

Instead of quince, you can take other fruits from the list of permitted ones.

Cabbage cutlets

Ingredients: cabbage – 1 kg, semolina – 0.5 cups, milk – 100 ml, eggs – 3 pcs.

Peel the cabbage, chop finely and place in a saucepan. Pour hot milk into it, place the pan on the stove, cover with a lid and simmer until tender, about 30–40 minutes. Gradually add semolina into the finished cabbage, stirring continuously to avoid lumps, and continue to simmer for another 5-10 minutes. After this, remove the pan from the heat, add the egg yolks to the cabbage, mix well and cool. Prepare cutlets from the cooled mixture and bake in the oven. Serve the cutlets with milk or sour cream sauce.

Cauliflower in an omelet

Ingredients: cauliflower – 200 g, butter, egg whites – 2 pcs., milk – 50 ml, sour cream – 30 ml.

Boil the cauliflower, separate it into small pieces; then place the buns in a single-serve frying pan, greased with oil, pour in the egg whites mixed with milk, sprinkle with sour cream and bake. Serve the cabbage in the same pan in which you baked it.

Ingredients: cottage cheese – 250 g, sugar – 3 tbsp. l., oil - 2 tbsp. l., flour - 1 tbsp. l., egg - 1 pc., sour cream - 2 tbsp. l.

Squeeze fresh cottage cheese under a press and rub through a hair sieve. Grind the butter in a porcelain bowl, add the yolk, a pinch of salt, granulated sugar, flour, sour cream. Stir well, combine with grated cottage cheese and knead until smooth. Place on a board sprinkled with flour, divide into portions, give them a round shape, coat with beaten yolk, roll in breadcrumbs and bake in the oven (under no circumstances should you fry!).

Cheesecakes with carrots

Ingredients: cottage cheese – 250 g, carrots – 2 pcs., butter – 2 tbsp. l., semolina - 2 tsp. l., egg – 1 pc., sugar – 1 tbsp. l., flour - 2 tbsp. l., salt.

Peel the carrots and grate them. Melt butter in a frying pan, put carrots in it, add 1/4 cup of water and simmer until tender. Gradually add semolina, heat the mixture, stirring, until the semolina swells. Then cool the mass and mix with cottage cheese, egg, sugar, flour. Form cheesecakes from the resulting mixture and bake in the oven (do not fry!).

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Chronic renal failure is a complication of various kidney diseases with severe damage to their functions. Products of protein metabolism accumulate in the body of a sick person, which leads to self-poisoning of the body. Dietary therapy in these cases is crucial.

General principles of diet therapy for chronic renal failure:

1. Limiting proteins in the diet to 20-70 g per day, depending on the degree of kidney failure.
2, Ensuring the energy value of food by increasing the amount of fats and carbohydrates.
3. Eating enough vegetables and fruits, taking into account their protein, vitamin and salt composition.
4. Appropriate cooking of foods to improve appetite.
5. Regulating the intake of salt and water into the body, depending on the presence of edema, blood pressure and kidney condition.

In the initial stage of the disease in the diet, the amount of protein is slightly limited (up to 70 g or 1 g of protein per 1 kg of the patient’s body weight).
Recommended consumption proteins of plant origin, which are found in bread, vegetables, nuts, legumes, and cereals. Metabolic products of these proteins are more easily excreted from the body. In addition, plant products contain a large amount of alkaline compounds, which inhibits the development of acidosis.

To ensure sufficient energy value of the diet, it is necessary to eat a variety of fats and carbohydrates, especially those contained in vegetables and fruits.

Salt limited slightly. Food is prepared without salt, but you can consume 5-6 g of salt per day. If the patient experiences an increase in the amount of urine excreted (polyuria), then the amount of salt can be increased to 5-6 g per 1 liter of urine.

Liquid quantity also should not exceed the amount of urine excreted over the past day by more than 500 ml. A sufficient amount of fluid helps remove metabolic products from the body.

Once a week there is a fasting day (sugar, watermelon, pumpkin, potato, apple).

the amount of protein is sharply limited (up to 20-40g per day). The main part of the proteins (70-75%) should be proteins of animal origin (milk, eggs, meat, fish) to provide the body with essential amino acids.

Due to the sharp limitation in the amount of proteins the energy value of the diet increases due to milk and vegetable fats, as well as carbohydrates. To improve taste, spices, herbs, sour vegetable and fruit juices (lemon, orange, tomato, etc.) are added to dishes.

Per day you can consume 2-3g of salt . If there is no edema, chronic circulatory failure, or high blood pressure, then the patient can consume 3 g of salt per day.

Liquid quantity (including first courses) that a patient can drink should not exceed the amount of daily diuresis (urine excretion) for the previous day by more than 500 ml. The liquid can be consumed as diluted fruit and vegetable juices or hydrocarbonate mineral waters (Borjomi, Luzhanskaya No. 1, Polyana Kvasova).
Food should be boiled; meat and fish can be lightly fried after boiling.

excluded from the diet foods and drinks that irritate the kidneys (strong coffee, tea, cocoa, chocolate, spicy and salty snacks, meat broths, fish and mushroom decoctions, alcohol). Meals - 5-6 times a day.

In advanced stages of renal failure Deserves attention Giordano-Giovanetti type diet, which can be used for a long time. This is a low protein diet that contains 18-25g of egg white to meet the body's need for essential amino acids.

The energy value of the diet, 2000-2800 kcal, is provided mainly by fats (120-130g) and carbohydrates (230-380g). Salt added in an amount of 2-5g.
Liquid is not limited and corresponds to daily diuresis.

Bread, meat and fish are excluded, as they increase acidosis.

Widely used vegetables, fruits, sugar, jam, marmalade, honey, vegetable oil, milk fats. To improve the taste, spices are added: dill, bay leaf, cinnamon, cloves, allspice, parsley, vanillin. Irritating seasonings are prohibited: horseradish, garlic, radish, mustard.

Here is one interpretation of this diet

1st breakfast: boiled potatoes – 200g, egg – 1 pc., tea with sugar, jam (honey) – 50g.
2nd breakfast: sour cream – 200g, tea with sugar.
Lunch: rice soup - 300g (drained butter - 5g, sour cream - 20g, potatoes - 100g, carrots - 20g, rice - 30g, onions - 5g, tomato juice - 5g), vegetable stew - 200g (drained butter - 10g, carrots - 70g, beets - 100g, rutabaga - 100g), fresh apple jelly - 200g.
Dinner: rice porridge - 200g (rice - 50g, sugar - 5g, milk - 100g, drained butter - 5g), tea with sugar, jam (honey) - 50g.
All day: drain. butter - 70g, sugar - 100g, egg - 1 pc., tea.

In severe cases of renal failure, hemodialysis is performed using an artificial kidney device. - purification of blood from metabolic products of proteins and other substances. With chronic hemodialysis, patients may develop complications due to nutritional imbalance, since amino acids are removed during the procedure. They need to be replenished by expanding the diet.

Diet of patients with chronic renal failure, who are on chronic hemodialysis, should contain 0.75-1 g of protein per 1 kg of patient body weight per day. When the hemodialysis time is increased to 30 minutes per week, the amount of protein is increased to 1.2 g per 1 kg of the patient’s body weight.

Food is prepared without salt. If blood pressure is low and there is no swelling, the patient is allowed to consume 2-3g of salt per day.

Due to the fact that as a result of repeated hemodialysis the amount of potassium, calcium, phosphorus in the body may increase, limit consumption vegetables, fruits, dairy products, legumes, cabbage, mushrooms. Fruits such as apricots, raisins, prunes, bananas, dried fruits excluded from the diet completely .

Liquid quantity limit to 700-800 ml per day. Allowed to drink a small amount of fruit juices (lemon, apple, cherry, tomato), through which the body receives vitamins. Spices are added to dishes that do not irritate the kidneys (see above).

The energy value of the diet is 2800-3000 kcal. Chemical composition of the diet: proteins - 60g (of which ¾ are of animal origin), fats - 110g, carbohydrates - 450g. Meals - 6 times a day in small portions.

In addition to the above products limit consumption black currants, melon, peaches, rhubarb, celery, chicory. Prohibited spicy and salty dishes, meat broths, fish and mushroom broths, canned food, sausages, smoked meats, chocolate.

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Therapeutic diets Diet after hemorrhoid removal Diet for exacerbation of hemorrhoids Diet for normal hemorrhoids Fasting days for kidney diseases Diet for atopic dermatitis Diet for kidney cysts with nephrotic syndrome Diet for kidney cysts with symptoms of kidney failure Juice therapy for spinal diseases Diet for acute bronchitis Diet for chronic bronchitis Diet - recovery after stroke Dietary food for colds Diet for phosphate kidney stones Diet for oxalate kidney stones Diet for urate kidney stones Diet for salt deposits Diet for zero stomach acidity Diet for cerebrovascular accidents and hypertension Some dietary recommendations after goiter removal Diet for hypertension General principles of nutrition after gallbladder removal Some dietary recommendations for diabetes Diet for vegetative-vascular dystonia Nutrition for hypotension Therapeutic menu to support the liver Nutrition for hiatal hernia Fasting days for various diseases Nutrition for glaucoma Diet for anemia and erythrocytosis Diet - cleaning blood vessels from cholesterol Diet to normalize cholesterol levels Fasting diets for heart disease Diet for stroke prevention Diet therapy for heart disease Diet after a heart attack Diet for arrhythmia Diet for diabetes Diet for heartburn sufferers Diet for constipation Diet therapy after flu and infectious diseases

In chapter Diet for kidney failure presents the characteristics of the diet for renal failure in the initial and severe stages, excluded and recommended foods and dishes, chemical composition, culinary processing of products, diet, daily set of products, menu, fasting days, as well as recipes for dishes recommended by nutritionists for a diet for renal failure .

Chronic kidney failure, which occurs with chronic nephritis, bilateral pyelonephritis, renal amyloidosis, nephrosclerosis, is a violation of the nitrogen excretory function of the kidneys, as a result of which protein metabolic products accumulate in the body, the amount of residual nitrogen in the blood increases, and water-salt metabolism is disrupted.

In the most severe degree of kidney failure, the body is poisoned by protein metabolic products (uremia).

Basic principles of diet for kidney failure:

Limit proteins to 20-70g per day, depending on the severity of kidney failure.

Regulation of the intake of table salt, taking into account the severity of edema, hypertension, and protein excretion in the urine.

Providing caloric intake from fats and carbohydrates.

In the initial stage of renal failure, it is prescribed

Diet for kidney failure in the early stages contains 70 g of protein (of which up to 30% animal proteins) or 60 g of protein, of which 40-50% animal proteins.

Diet for advanced renal failure contains 20g of protein (diet No. 7a) or 40g of protein (diet No. 7b), 70-75% of which are animal proteins from meat, fish, dairy products, eggs. Fluid consumption is 1-1.5 liters per day, but it should correspond to the amount of urine excreted over the previous day, plus 0.4-0.6 liters.

In case of severe renal failure, they are first prescribed, and when the patient’s condition improves, they are transferred to, against which diet 7a is periodically applied.

While using diet 7a, the patient is periodically given 2-4 g of salt on his hands to add salt to the food. When edema appears, salt is again limited to 1 g or eliminated.

The diet for renal failure includes carbohydrate fasting days:

Apple-sugar, rice-compote, potato.

1.Apple-sugar diet: 1.5 kg of ripe or baked apples per day, divided into 5 doses of 300 g, 50-100 g of sugar

2. Rice-compote diet: per day 1.5 fresh fruits or 240g dried fruits, 120g sugar, 50g rice. Cook compote and rice porridge in water. 1 glass of sweet compote 6 times a day, 2 times with sweet rice porridge cooked without salt in water.

3. Potato diet: 1.5 kg of potatoes per day. Boil potatoes in their skins without salt or bake. Eat 300g of potatoes 5 times a day.

4. Special potato diet, prescribed for chronic glomerulonephritis with renal failure: potatoes - 1 kg (net weight), other vegetables or fruits - 300g, vegetable oil - 50g, butter - 70g, sugar - 50g.

Culinary treatment for diet in advanced stages of renal failure:

Culinary processing of products for diets No. 7a and 7b without mechanical sparing.

The food is boiled, followed by baking and light frying.

Diet for renal failure, diet:

Eat food 5-6 times a day.

Food is prepared without salt, bread is given salt-free.

Exclude from the diet for severe renal failure:

1. Regular bread, flour products with added salt.

2. Meat, fish, mushroom broths, milk soups, soups with cereals (except sago) and legumes.

3. All meat and fish products (canned food, sausages).

5. All cereals (limit rice) and pasta.

6. Pickled, salted, pickled vegetables.

7. Sorrel, spinach, cauliflower, legumes, garlic, radish, mushrooms.

8. Chocolate, ice cream, milk jelly.

9. meat, mushroom, fish sauces, mustard, horseradish, pepper.

10. Natural coffee, cocoa, mineral waters containing sodium.

11. Pork, beef, lamb fats.

Diet No. 7a:

-Soups vegetarian with sago, vegetable, potato, fruit, taking into account the permitted liquid. Soups are seasoned with sour cream, herbs, boiled and then sautéed onions.

- Meat and fish dishes: 50-60 (gross weight) lean beef or veal, pork (meat without fat), rabbit, chicken, turkey, fish. Boiled meat and fish, baked or lightly fried after boiling, in pieces or chopped.

- Dairy products: 60g of milk, cream, sour cream, cottage cheese - excluding meat and fish.

-Cereals- only sago, limited rice, only protein-free pasta. They prepare dishes with milk or water in the form of porridges, pilaf, cutlets, casseroles, and puddings.

-Eggs: 1/4-1/2 eggs per day (omelet, soft-boiled).

- Vegetables: potatoes 200-250g and fresh vegetables 400-450g (gross weight) in the form of various dishes. Boiled and fried onions as an additive to dishes, dill and parsley.

- Various fruits and berries in raw, dried, baked form, sugar, honey, jam, non-chocolate candies, jelly, compote, jelly.

- To improve taste dishes use greens, sour fruit and vegetable juices.

- Snacks: vegetable salads with vegetable oil.

-Sauces: tomato, sour cream, sweet and sour sauces, vegetable and fruit sauces. Fried onions after boiling, citric acid, cinnamon, vanillin.

.- Fats: unsalted butter, ghee, vegetable oil.

- Flour products: 100g of protein-free, salt-free bread with corn starch, in the absence of such bread, 50g of wheat-free salt-free bread or other salt-free flour products baked with yeast.

-Beverages: fruit and berry juices, tomato juice, rosehip decoction, weak tea with lemon.

Diet 7b:

In diet 7b, the amount of protein is doubled by including 125g of milk and sour cream, 125g of meat or fish, 1 egg. Cottage cheese is given only when meat and fish are excluded or reduced.

Also in diet 7b the amount of potatoes is increased to 300g, other vegetables - to 650g, salt-free, protein-free bread to 150g, sago (rice).

Daily set of products for diet No. 7a(Samsonov M.A. 1981):

Salt-free, protein-free bread - 100g, meat - 62g, eggs - 1/4pcs, milk - 30g, sour cream - 30g, vegetable oil - 7g, butter - 90g, sugar - 80g, sago - 55g, potatoes - 235g, white cabbage - 150g, carrots - 70g, beets - 130g, onions - 30g, green onions - 15g, greens - 10g, radishes - 20g, fresh cucumbers - 20g, parsley - 7g, tomato - 7g, flour - 18g, corn starch - 70g.

Daily set of products for diet No. 7b(Samsonov M.A. 1981):

Protein-free, salt-free bread - 150g, meat - 125g, milk - 80g, eggs - 48g (1 piece), sour cream - 45g, butter - 80g, vegetable oil - 20g, sago - 70g, sugar - 110g, potatoes - 335g, carrots - 80g, white cabbage - 225g, beets - 200g, greens - 20g, green onions - 15g, onions - 40g, green peas - 20g, radishes - 35g, fresh cucumbers - 40g, parsley - 7g, tomato - 15g, flour - 28g , corn starch - 80g.

For acute renal failure as a result of poisoning (for example: sublimate, mercury), acute infections, injuries, acute nephritis, severe burns, diet 7a (proteins 20-25g), of which animal proteins - 70-75%, is prescribed. The amount of fluid administered should correspond to the amount of urine for the previous day +0.5 l.

The calorie content of the diet should be sufficient to prevent the breakdown of proteins to replenish the body's energy costs.

In end-stage renal failure with a sharp deterioration in kidney function, 20-25 g of protein are prescribed, salt is increased to 8-12 g, free liquid - to 2 liters.

Diet for kidney failure depending on the stage of kidney failure:

1.initial stage- diet No. 7 when replacing protein-free bread (1g protein per 1 kg of patient weight) or diet No. 7 with fasting days with diet 7b (protein 40g, animal - 70-75%) or diet No. 7 (protein 70g, vegetable - 70-75% ).

2.Expressed stage:

- low-symptomatic: diet 7b with periodic administration of diet 7 (load days).

- multisymptomatic: diet 7b with fasting days diet 7a (protein 20g, of which animals - 70-75%).

3.Final stage:

-uncomplicated: for hemodialysis, diet No. 7 is prescribed with fasting days, diet 7b or diet 7g (protein 60g, of which 75% are animals).

- complicated: diet 7a with loading days diet 7b.

Diet menu No. 7a for 1 day:

1st breakfast: sago milk porridge, apple and carrot cutlets baked in vegetable oil, tea.

2nd breakfast: fresh fruits.

Dinner: 1\2 servings of vegetarian soup from prefabricated vegetables, boiled potatoes, boiled meat with tomato sauce, jelly.

Afternoon snack: decoction of wheat bran with sugar.

Dinner: vegetable salad in vegetable oil, sago pilaf with fruit. Tea.

For the night: fruit juice.

Diet menu No. 7b for 1 day:

1st breakfast: apple and rice pudding, vegetable salad with vegetable oil, tea.

2nd breakfast: raw grated carrots with sugar

Dinner: vegetarian soup from prefabricated vegetables (1/2 servings), boiled potatoes, boiled chicken with milk sauce, dried fruit compote.

Afternoon snack: decoction of wheat bran with sugar.

Dinner: apple pancakes, 1 soft-boiled egg, tea.

Therapeutic nutrition is prescribed simultaneously with anti-inflammatory, desensitizing and symptomatic therapy.
Basic requirements for the dietary diet of patients with acute diffuse glomerulopephritis: 1) limitation of table salt and water; 2) limiting simple carbohydrates; 3) protein restriction; 4) reducing the calorie content of the diet, taking into account the level of energy expenditure of the body; 5) exclusion of extractive substances from the diet and full provision of the patient’s body’s needs for vitamins and minerals.
Based on clinical experience, it is most advisable to prescribe sodium-free nutrition to patients with acute diffuse glomerulonephritis in the first 2-3 days in the form of contrast days, the choice of which is determined by the patient’s tastes and his tolerance of technical foods and dishes. In this case, potato, apple, watermelon, pumpkin, or bapap, sugar, compote, kefir and other days are used. For the whole day, the patient is given 1.2 kg of boiled or baked potatoes, peeled, or 1.5 kg of ripe apples, or 1.5 kg of ripe peeled watermelon, or 150 g of sugar, or 1.5 liters of compote made from fresh fruits or dried fruits, or 1.2 kg of peeled bananas, or 1.2 kg of baked or boiled pumpkin with sugar. The total amount of product is divided into 5 servings and the patient is given 5 pas per day.
The amount of liquid recommended for the patient (rose hip decoction, diluted fruit juice, weak tea, milk, etc.) is determined as follows: 400 ml of liquid is added to the daily diuresis, i.e. if the patient excreted 500 ml of urine per day, then the allowed amount liquid during the day will be 900 ml. On watermelon and compote fasting days, the patient is not given liquid.
Prescribing sodium-free fasting days to a patient with acute nephritis in the first 2-3 days helps to reduce edema syndrome, lower blood pressure, and improve general condition. From the 3-4th day of treatment, the patient should be transferred to salt-free diet No. 76, containing 40 g of protein, 80 g of fat and 450 g of carbohydrates, with a total calorie content of 2700 kcal. Protein in this diet is introduced mainly from egg, milk and fish proteins, which are more easily absorbed by the body and contain fewer extractive substances. This protein-deficient diet is the mainstay in the treatment of patients with chronic renal failure. Approximate one-day diet menu No. 7b.
In acute diffuse glomerulonephritis, the excretory function of the kidneys, as a rule, is not significantly impaired, therefore, as the patient’s condition improves, the diet must be expanded, primarily by increasing the protein quota. At the beginning of the 3rd week of the acute period of the disease, provided that the severity of urinary syndrome decreases, the patient is transferred to salt-free diet No. 7. Chemical composition of the diet: proteins 80 g, fats 85 g, carbohydrates 450 g. Calorie content of the diet is 2900 kcal.
In table An approximate one-day menu for this diet is given.
The patient should remain on this diet until the end of his hospital stay. If, when switching to diet No. 7, the patient’s condition has worsened somewhat, it is necessary to prescribe him diet No. 76 again for 2-3 days in order to then return to diet No. 7. This “zigzag” sometimes has to be repeated twice in order to adapt the body patient to new nutritional conditions.
When the patient is discharged from the hospital and his condition is progressively improving, the amount of protein can be increased to 90 g and meat can be included in the diet mainly in boiled form, followed by baking. The content of table salt and simple carbohydrates, which have a sensitizing effect, is limited in the next 3-4 months, i.e. until the residual effects of acute nephritis are completely eliminated,

Approximate one-day menu of diet No. 7 (2881 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Soft-boiled eggs (2 pcs.)	48	10,2	10,9	0,5
Crumbled buckwheat porridge with butter	90	4,3	4,8	25,0
Tea with milk	200	1,4	1,7	2,3
Lunch
Pumpkin porridge with semolina	280	8,0	9,0	49,0
Dinner
Vegetarian borscht (1/2 serving)	250	2,3	6,8	16,7
Boiled meat	55	15,9	3,2	-
Fried potato	125	2.6	7,9	30,1
Fresh fruit compote	200	0,3	-	27,8
Afternoon snack
Carrot-apple balls baked	230	6,7	7,2	43,0
Fruit pilaf (1/2 serving)	90	1,9	6,1	38,2
Apple juice	200	0,8	-	23,4
For the night
Prune jelly	200	0,5	-	46,9
All day
Bran bread, salt-free	250	25,0	12,0	91,0
Sugar	50	-	-	49,9
Butter	20	0,12	16,5	0,18
Total		79,5	86,1	445,7

Therapeutic nutrition for chronic renal failure

Chronic renal failure (CRF) is a symptom complex caused by irreversible, severe damage to kidney function. Renal failure cannot be reduced only to a violation of the nitrogen excretion function of daughters and the accumulation of nitrogenous waste in the body, the toxic effect of which has long been considered the main cause of uremia. Deterioration of kidney function leads to severe changes in water and electrolyte metabolism, as well as metabolic disorders, which, along with azotemia, is of significant importance in the pathogenesis of chronic renal failure and often determines the course of uremia and its outcome.
The goal of conservative therapy for chronic renal failure is to influence water and electrolyte disturbances, acidosis, cardiovascular failure, arterial hypertension and other disorders of the internal organs. Dietary therapy is an obligatory component of complex treatment of patients with chronic renal failure.
The concentration of end products of nitrogen metabolism (residual nitrogen, urea, uric acid, creatinine, etc.) in the blood serum depends on the amount of protein supplied with food, the level of protein catabolism and the degree of renal failure. Since most patients with chronic renal failure cannot significantly improve renal function with medications alone, a low-protein diet is the only way to reduce azotemia.
Currently, dietary treatment of chronic renal failure is based on the following basic principles: 1) limiting dietary protein to 20-40-60 g per day, depending on the severity of renal failure; 2) ensuring sufficient calorie intake from fats and carbohydrates, corresponding to the body’s energy expenditure, full provision of vitamins, macro- and microelements; 3) in case of arterial hypertension, restriction of salt and water entering the body to those minimum limits at which it is possible to ensure the maintenance of normal water and electrolyte composition of the internal environment of the body. A significant restriction of protein in food can lead to a decrease in total protein in the body, which limits the formation of enzymes, antibodies, and hormones that are necessary for the normal functioning of the body. Consequently, the construction of a dietary diet for a patient with chronic renal failure comes down to determining the optimal amount of protein that will not cause a dangerous increase in the content of nitrogenous wastes, and, at the same time, will not lead to the breakdown of the body’s own proteins due to protein starvation. In other words, in patients with chronic renal failure it is necessary to maintain nitrogen balance in conditions of reduced protein intake from the outside.

Therapeutic diets for patients with chronic renal failure

Based on the created protein-free products, the Institute of Nutrition of the Academy of Medical Sciences developed two versions of a low-protein diet containing 20 g of protein (diet No. 7a) and 40 g of protein (diet No. 76).
In diets No. 7a and 76 3/4 protein is animal protein (meat, eggs, milk) as the most complete in terms of essential amino acids. This proportion of animal protein made it possible to provide diet No. 7a with the minimum amount of essential amino acids at which nitrogen balance is observed, and diet No. 76 - the amount of essential amino acids corresponding to the daily need for them to maintain nitrogen balance in the body of an adult (Table).

Content of essential amino acids in low-protein diets (in grams)

Caloric content of diets is provided by fats and carbohydrates, the content of which does not significantly exceed the physiological norm. When preparing diets, great attention must be paid to the taste of the diet. To improve the taste of food, it is allowed to add spices, herbs, sour vegetable and fruit juices (lemon, orange, cherry plum, tomato, etc.).
Both diets are hyposodium. All food is prepared without salt; its content in the products themselves is 2-3 g per day. If the patient does not have cardiovascular failure, high blood pressure, or severe swelling, an additional 3 g of salt is given to his hands. Patients can consume 1-1.5 liters of fluid, taking into account daily diuresis. The liquid is given in the form of diluted fruit and vegetable juices, alkaline mineral water or intravenous drip infusions of 4% sodium bicarbonate solution and 5% glucose solution in case of severe intoxication.
A daily set of products included in diets No. 7a and 7b, an assortment of dishes recommended for patients with chronic renal failure, characteristics of diets and a one-day menu are given below.

Diet No. 7 a

Indications for use. Chronic kidney disease with a pronounced impairment of nitrogen excretory function and severe azotemia.
Special purpose. Sparing kidney function; improving the removal of nitrogenous wastes and under-oxidized metabolic products from the body; preventing the accumulation of nitrogenous waste in the blood, slowing the development of uremia, as well as reducing hypertension.
General characteristics. A diet with the exclusion of CLR by a sharp restriction of table salt (depending on the severity of the hypertensive syndrome), a sharp restriction of protein (up to 20 g) mainly from plants, while simultaneously introducing into the body the minimum required amount of essential amino acids with complete animal protein. Avoid substances and substances that irritate the kidneys (alcohol, nitrogenous extractives, strong coffee, tea, cocoa and chocolate, spicy, salty snacks). The diet includes foods that contain a small amount of protein and are high in calories (various sago dishes, protein-free bread made from maize starch, mashed potatoes and mousses made from swelling starch). To provide the body with vitamins, give various juices (watermelon, melon, cherry, grape, etc.).
Culinary processing. All dishes are prepared without salt. Meat and fish are served boiled or then fried.
Chemical composition and calorie content of diet No. 7a. Proteins 20 g (of which 15 g are animals), fats 80 g (of which 50-55 g are animals), carbohydrates 350 g. Calorie content 2200 kcal. Table salt 1.5-2.5 g (in products). Vitamin content: retinol - 0.7 mg, carotype - 5.5 mg, thiamine - 0.45 mg, riboflavin - 0.47 mg, nicotinic acid - 4.5 mg, ascorbic acid - 268.5 mg. Mineral content: calcium - 230 mg, potassium - 1630 mg, magnesium - 100 mg, phosphorus - 390 mg, iron - 16 mg.
The total amount of free liquid is 1-1.5 liters. The weight of the daily ration is 2.3 kg. The food temperature is normal. The number of meals is 5-6 times a day.

Bread and bakery products. Protein-free bread made from maize starch, white wheat bran (achloride) is baked without salt.
Various soups, with sago, vegetables, fruits, vegetarian, prepared without salt.
Meat and poultry dishes. Lean varieties of beef, veal, chicken, turkey, rabbit, boiled and then fried, in pieces or chopped.
Fish dishes. Low-fat fish (pike perch, pike, navaga, perch, roach) boiled and then fried, sliced ​​or chopped.
Dishes and side dishes made from vegetables and herbs. Potatoes, carrots, beets, cauliflower, lettuce, tomatoes, fresh cucumbers, parsley, green onions. Boiled, in its natural form.
Dishes and side dishes of cereals, legumes and pasta are excluded or sharply limited. Instead, they give dishes from sago and special pasta - with water and milk in the form of porridges, puddings, casseroles, cutlets, pilaf.
Egg dishes. Protein omelet and for preparing various dishes (no more than one egg per day).
Milk, dairy products and dishes made from them. Whole milk, kefir, acidophilus, yogurt, sour cream, cream (all in limited quantities).
Sauces and spices. Milk, tomato, protein-free, vegetable marinade sauce with tomato. Sweet and sour vegetable and fruit sauces with the exception of meat, fish and mushrooms

Approximate one-day menu for diet No. 7a (2440 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Sago pudding with apples	200	3,2	6,3	48,0
Applesauce with proteins	140	1,3	0,9	41,2
Apricot juice	200	0,8		28,4
Lunch
Fruits (apples, berries, etc.)	100	0.4	-	11,5
or melons (watermelon, melon)	350	1,7	-	32,0
Dinner
Soup from prefabricated vegetables vegetarian (1/2 serving)	250	4,8	9,7
Boiled meat (1/2 serving)	26,5	6,95	1,6	-
Apple, prune salad, apricots	150	1,5	5,6	39,3
Cranberry jelly	200	0,2	-	38,9
Afternoon snack
Rose hip decoction	200	-	-	-
Dinner
Sago pilaf with fruits (x/2 servings)	90	0,47	5,92	40,72
Vegetable salad with vegetable oil	150	1,5	9,4	11,7
Tea with sugar (sugar 10 g)	200	-	-	9,5
For the night
Plum juice	200	0,4	-	33,2
All day
Protein-free bread Butter Sugar	100 60 40	0,83 0,36	2,5 49,5	0,5
Total		20,5	86,7	400,2

Approximate one-day menu of diet No. 7b (2800 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Sago pudding with apples	270	4,32	8,58	65,03
Applesauce with proteins	140	1,3	0,9	41,2
Apricot juice	200	0,8		28,4
Lunch
Grated raw carrots with sugar	155	1,95	-	16,2
Dinner
Vegetarian mixed vegetable soup (1/2 serving)	250	9,7
Boiled meat	55	15,9	3,2	-
Protein-free tomato sauce	50	0,5	3,97	3,7
Salad of apples, prunes and apricots	150	1,5	5,6	39,3
Cherry puree-mousse	140	0,78	-	20,2
Afternoon snack
Rose hip decoction	200	-	-	-
Dinner
Sago pilaf with fruits	180	0,94	11,84	81.44
Protein omelet	110	8,3	6,5	3,32
Tea without milk	200	-	-	-
For the night
Plum juice	200	0,4	-	33,2
All day
Sugar	40	-	-	39,8
Butter	40	0,24	33,0	0,36
Protein-free starch bread	150	1,24	3,7	71,62
Total		39,9	82,4	483

Daily set of products included in diets 7a and 7b (gross)

Product Name	Product weight, g
	diet No. 7a	diet number 7b
Protein-free bread, white or bran (achloride)	100	150
Meat	62	125
Eggs	13 (1/4 pcs.)	48 (1 piece)
Milk	30	80
Sour cream	30	45
Butter	90	80
Vegetable oil	7	20
Sugar	80	110
Sago	55	70
Potato	235	335
White cabbage	150	225
Carrot	70	80
Beet	130	200
Bulb onions	30	40
Green onion	15	15
Greenery	10	20
Green pea	-	20
Radish	20	35
Fresh cucumbers	20	40
Parsley	7	7
Tomato	7	15
Flour	18	28
Corn starch	70	80

Beverages. Strong tea, diluted fruit juices, raw vegetable juices. Rose hip decoction.
Fats all kinds, with the exception of refractory ones (lamb, pork and beef).
Sweet dishes, sweets, fruits, berries. Jelly, puree-mousse prepared with swelling starch, sugar, honey, jam, sweets. Any fruits, berries, raw or boiled. Fruit juices. Pumpkin, watermelon, melon are recommended.
In table An approximate one-day menu for diet No. 7a is given.

Diet No. 7b

Indications for prescribing the diet, intended purpose, general characteristics of the diet, culinary processing are the same as for diet No. 7a.
Proteins 40 g (of which 25-30 g are animals), fats 80-90 g (of which 60-65 g are animals), carbohydrates 450 g. Calories 2800 kcal. Table salt 2-3 g (in products). Vitamin content: retinol -0.95 mg, carotene -5.5 mg, thiamine -0.7 mg, riboflavin -
1.1 mg, nicotinic acid -7.5 mg, ascorbic acid - 282.7 mg. Mineral content: calcium - 460 mg, potassium - 2650 mg, phosphorus - 690 mg, iron - 19.3 mg, magnesium - 200 mg. The total amount of free liquid is 1-1.5 liters. The weight of the daily ration is 2.5 kg. The temperature is normal. The number of meals is 5-6 times a day.
In table A one-day diet menu No. 7b is given.
In table The daily set of products included in diet No. 7 a and 7 b is given.
Dietary treatment with a sharp restriction of protein in the diet requires a sufficient caloric content of the diet (2200-2800 kcal) and a maximum reduction in vegetable proteins in it. At the Institute of Nutrition of the Academy of Medical Sciences, a team of employees of the technology department under the leadership of G. S. Korobkina developed protein-free products from cereal starch and swelling amylopectin starch. These products include protein-free bread, confectionery (cakes, cookies), pasta, noodles, vermicelli, cereals (such as semolina, rice, etc.), fruit mousses, jellies, creams. Artificial sago made from corn starch is widely used as a cereal substitute.

Chemical composition and calorie content of special dietary products and dishes recommended for use in low-protein diets

The chemical composition of some protein-free foods and dishes is presented in table.

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
Protein-free bread from corn starch	100	0,83	2,5	47,8	280
Potato soup with sago	300	1.47	3,9	19,9	124
Sago cutlets	140	0,4	7.9	49,4	288
Sago cabbage rolls	250	5.2	11.0	30,2	252
Potato zrazy, stuffed sago with onions	200	5,6	12,2	55,9	381
Sago porridge, crumbly oil, water	200	0,5	11,8	66,0	383
Sago porridge with milk	150	1,58	3,8	25,3	151
Sago pudding with apples	200	3,2	6,3	48,0	276
Sago casserole with dried apricots	200	4,33	12,1	75,1	450
Sago and apple casserole	260	3,7	12,0	65,3	407
carrots Sago pilaf with fruits	180	0,94	11,8	81,5	463
Cherry puree-mousse with swelling starch	140	0,78	-	20,2	207
Plum shore mousse with swelling starch	140	0,38	-	53,3	220

Therapeutic nutrition for end-stage renal failure

Currently, the treatment of patients with end-stage renal failure (ESRD) is based on the use of chronic hemodialysis in combination with dietary therapy. When using hemodialysis, patients may develop some complications due to nutritional imbalance. Due to the fact that in patients with terminal uremia the metabolism of proteins and amino acids in the body is disrupted, the leading direction in building a dietary regimen is to determine the adequate amount of protein in the diet and its qualitative composition. Hemodialysis treatment, along with the washout of toxic substances, is accompanied by a loss of amino acids, which leads to significant changes and restructuring of the amino acid spectrum of blood serum. Depending on the duration of the procedure, a different percentage of decrease in the total concentration of amino acids in the blood serum is noted: with 6-hour hemodialysis, the level of amino acid nitrogen decreases by 16-20% of the original, with 9-10 hours - by 20-30%. During hemodialysis, valine, threonine, isoleucine, arginine and histidine are subject to the greatest leaching from essential amino acids; of the replaceable ones - series, citrulline, alanine, ornithine. Under the influence of hemodialysis, the content of strait, cystine, glycine and aspartic acid is normalized in patients. The concentration of methionine and tryptophan decreases. The "artificial kidney" filters everything that passes through the burrows of the artificial membrane. Replenishment of amino acids lost in the dialysate solution should be ensured by a rationally expanded diet.
The diet should be salt-free (hyponodium). All food is prepared without salt. If the patient does not have high blood pressure, edema, or heart failure, 2-3 g of salt are given to him.
Due to the risk of developing hyperkalemia in a patient with ESRD, it is recommended to limit the amount of potassium administered with food to 2500 mg per day. Limit the amount of phosphorus introduced with non-protein foods (legumes, red cabbage, mushrooms, etc.), as well as dairy products containing a significant percentage of calcium and phosphorus, since the increased content of these minerals contributes to the development of renal osteodystrophy.
The diet of patients with ESRD undergoing regular hemodialysis should contain 0.75-1 g of protein per 1 kg of body weight per day. The amount of protein in the diet also depends on the number of hemodialysis sessions per week: when increasing the hemodialysis time to 30 hours per week, it is necessary to increase the protein quota to 1.2 g/kg. The amount of vitamins in the diet must correspond to their physiological norm; the content of ascorbic acid must be increased to 250 mg per day. For patients with ESRD, diet No. 7g is recommended.
Chemical composition and calorie content of diet No. 7g. Protein 60 g (of which 3/< животного происхождения), жиров 110 г, углеводов 450 г. Калорийность 3000 ккал.
Vitamin content: retinol - 1.55 mg, carotype - 4.96 mg, thiamine - 1.34 mg, riboflavin - 2.5 mg, nicotinic acid - 13.44 mg, ascorbic acid - 250 mg. Mineral content: potassium - 2542.5 mg, calcium - 624.5 mg, magnesium - 301.6 mg, phosphorus - 1192.7 mg, iron - 22.3 mg. Daily diet contains 45 g of animal protein, which is introduced in the form of meat, eggs and fish, provides the body with an optimal amount of essential amino acids. The caloric content of the diet is provided by fats and carbohydrates.
Much attention should be paid to the taste of the diet. A variety of products are recommended, fresh vegetables and fruits, melons (cucumbers, tomatoes, new potatoes, apples, plums, watermelon, etc.), adding spices, sour vegetable and fruit juices (lemon, plum, apple, cherry, tomato, etc. ). However, due to the possibility of developing hyperkalemia, strict control over the amount of fruits and fresh vegetables consumed is necessary, and some of them are prohibited (apricots, bananas, dried fruits, legumes, etc.).
The amount of free fluid is limited to 700-800 ml, with anuria to 300-400 ml.
The daily set of products included in diet No. 7g is presented in table.
Table 78

Daily set of products included in diet No. 7g (gross)

Product name	Product weight, g	Product name	Product weight, g
White bread salt-free	100	Flour	10
		Tomatoes	45
Salt-free black bread	100	Fresh cucumbers	40
		Green pea	35
Meat or fish	100	Apples	250
Egg	120 (2.5 pcs.)	Cabbage	160
		Carrot	40
Milk	140	Beet	50
Sour cream	140	Bulb onions	8
Cottage cheese	25	Tomato paste	10
Butter	40	Green onion	10
Vegetable oil	35	Greenery	15
Sugar	60	Parsley	5
Potato	300	Honey	50

General characteristics of diet No. 7g. The diet provides for an optimal content of proteins, fats and carbohydrates, a sharp limitation of table salt (2-3 g contained in products), a limitation of free liquid to 700-800 ml per day, while simultaneously introducing into the body the maximum required amount of essential amino acids with a full-fledged animal protein. Full provision of the body with vitamins by including various fruit and vegetable juices in the diet.
Culinary processing. All dishes are prepared without salt. Meat and fish are given boiled or followed by frying, which reduces the amount of extractive substances.
Flour dishes and cereal dishes are limited due to their high vegetable protein content.
Meals are fractional (6 times a day).
List of recommended foods and dishes for patients with terminal uremia undergoing hemodialysis.
Salt-free white and black bread (200 g per day).
Soups. Vegetarian with various vegetables, borscht, beetroot soup, cabbage soup made from fresh vegetables with herbs and roots (250 ml) without salt, fruit soups.
Meat and poultry dishes. Low-fat varieties of beef, veal, chicken, turkey, rabbit, tongue, boiled or subsequently baked and fried. Meat, minced or in pieces (55 g per day).
Fish dishes. Different types of fish instead of meat, boiled or then fried.
Vegetable dishes and side dishes. Potatoes, white cabbage, cauliflower, lettuce, tomatoes, fresh cucumbers, beets, greens. Vegetables boiled or then fried. Allowed in kind.
Dishes and side dishes from cereals and pasta are limited, are used in the form of pilaf with fruit, casseroles, and boiled as a side dish.
Snacks. Vegetable and fruit salads, vinaigrette without pickles.
Eggs and dishes made from them. Whole soft-boiled eggs, omelettes, for preparing other dishes (2-3 pieces per day).
Dairy products and dishes made from them are limited. It is allowed to roll up to 200 g per day, cottage cheese in the form of pudding or casserole.
Fruits, berries, sweet dishes and sweets. Fruits and berries are best eaten raw, as well as baked or boiled. Sugar, honey, jam.
Beverages. Tea, weak coffee, rosehip infusion, raw fruit juices.
Sauces and spices. Milk sauce, sauce made with sour cream, cream, water. Sweet and sour vegetable and fruit sauces. Horseradish, mustard, pepper, vinegar, cinnamon, cloves in limited quantities.
Fats. Butter and vegetable oil. Refractory fats are excluded.
Limited to: scooping currants, cherries, melons, peaches, pineapples, rhubarb, raisins, currants, figs, prunes, red cabbage, celery, mushrooms, chicory.
Prohibited: spicy, salty dishes. Meat and fish broths, mushroom broths. Canned snacks, sausages, smoked meats, chocolate. Dried fruits, apricots, legumes,

Approximate one-day diet menu No. 7g (2950 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Soft-boiled egg (2 pcs.)	96	10,2	10,9	0,5
Vegetable Salad	150	4,0	11,4	18,0
Kissel	200	0,2	-	46,1
Lunch
Baked apple	120	0,4	-	29,3
Dinner
Vegetarian borscht with sour cream (1/3 portion)	250	2,15	6,76	12,69
Boiled meat	55	16,0	3,2	-
Fruit jelly (lemon)	125	2,9	-	20,0
Afternoon snack
Fruit mousse with swelling starch	140	0,4	-	53,3
Dinner
Potato zrazy with egg white in vegetable oil	160	6,3	14,5	43,0
Sour cream	100	2,1	28,2	3,1
Kissel	200	0,2	-	46,1
For the night
Rose hip decoction	200	-	-	-
All day
White achloride bread	150	12,4	1,2	78,8
Sugar	40	-	-	39,8
Butter	20	0,12	16,5	0,18
Honey or jam	50	0,2	-	38,85
Total		61,0	101,6	451,8

An approximate one-day menu for diet No. 7g is given in table.
Methodology for differentiated use of dietary nutrition in patients with chronic renal failure and end-stage renal failure. The prescription of low-protein diets for patients with chronic renal failure and the duration of their use are determined by the degree of renal failure. With glomerular filtration above 40 ml/min, significant protein restrictions are usually not required, since these patients tolerate quite significant protein loads quite well - 60-80 g of protein (1 g/kg body weight). When glomerular filtration decreases to 30 ml/min, it is necessary to limit protein in the diet to 40 g (i.e. 0.5 g/kg), which gives a completely satisfactory therapeutic effect. It should be borne in mind that 30 g of protein in the diet should be of animal origin (egg whites, cottage cheese, boiled meat). Vegetable proteins (bread, potatoes and other vegetables, cereals, fruits) should be only 10 g. In case of significant proteinuria, the content protein in food increases according to this loss (for every 6 g of urine protein, one chicken egg).
A diet containing 30 g of animal protein can be used in any hospital. On an outpatient basis, patients with chronic renal failure can slightly expand their dietary regimen, increasing the proportion of protein to 60 g, while using regular foods.
When glomerular filtration in patients with chronic renal failure decreases to 15 ml/min, the protein content in the diet is reduced to 20 g per day (0.25-0.3 g/kg) (diet No. 7a), and all this amount should be animal protein. Quite satisfactory treatment results can be obtained from the use of this diet with a filtration rate of about 10-5 ml/min. Only when glomerular filtration is less than 4-3 ml/min is it necessary to transfer patients to hemodialysis with appropriate dietary recommendations.
The main therapeutic diet for most patients with chronic renal failure is diet No. 7b, containing 40 g of protein. This diet is well tolerated by patients and can be used for a long time both in a hospital and on an outpatient basis.
The disappearance of uremic symptoms and a decrease in the level of nitrogenous waste in the blood occurs faster when using diet No. 7a, containing 20 g of protein, than diet No. 7b. The content of urea and residual nitrogen in the blood serum also decreases faster when prescribing diet No. 7a. However, in patients receiving this diet, as dyspeptic disorders disappear, the feeling of hunger gradually increases and weight loss is noted. Therefore, diet No. 7a cannot provide a positive nitrogen balance with prolonged use.
The most adequate diet for long-term use in kidney patients is diet No. 7b. Only in case of advanced renal failure, treatment should begin with diet No. 7a, and then, as the patients’ condition improves, transfer them to diet No. 7b, against the background of which diet No. 7a can be periodically applied in the form of “zigzags”. The duration of diet No. 7a is determined individually, but it is used for no more than 25 days.
When transferring a patient with terminal uremia to hemodialysis, he is prescribed diet No. 7g.
List of products recommended for transfer from home to patients with chronic renal failure. Fruit juices: orange, grape, cherry, pomegranate, tangerine, peach, plum, cherry, apple and others at the rate of 400 g per day.
Fruits and melons: quinces, pineapples, oranges, pears, grapes, cherries, strawberries, strawberries, raspberries, lemons, tangerines, peaches, plums, red and black currants, cherries, apples, as well as watermelon and melon at the rate of 100-120 g of fruits and 300-350 g of melons per day.
List of products recommended for transfer from home to patients with end-stage renal failure on regular hemodialysis. Fruit juices: apple, plum, cherry, black cherry, tomato, carrot at the rate of 150-200 g per day.
Fruits and melons: apples, plums, lemons, cherries, pears - 120 g; watermelon, melon at the rate of up to 300 g per day.
Vegetables: tomatoes, cucumbers, etc. up to 200 g per day.
The intake of fruit juices, fruits and vegetables must be alternated.

Nutritional therapy for nephrotic syndrome

Nephrotic syndrome is kidney damage with massive proteinuria, hypo- and dysproteipemia, widespread edema, hypercholesterolemia and other disorders. In approximately 76% of patients, the cause of nephrotic syndrome is glomerulonephritis; in other cases, amyloidosis, diabetic nephropathy, nephropathy of pregnancy, circulatory failure, etc.
Dietary therapy is based on the characteristics of the pathogenetic mechanisms of the disease. Against the background of the use of corticosteroid drugs, cytostatics and immunosuppressants, to compensate for the significant loss of protein, diet No. 7c is prescribed with a high protein content, a sharp limitation of table salt (sodium ions), liquid enriched with lipotropic factors (methionine, phosphatides), while fully providing the body with vitamins and minerals substances and microelements.

Diet No. 7b

Indications for use. Various chronic kidney diseases, amyloidosis, tuberculosis, rheumatism and collagenosis, accompanied by nephrotic syndrome.
Special purpose. Replenishment of protein loss, reduction of hypoproteinemia, dysproteinemia and hypercholesterolemia, reduction of domestic syndrome and proteinuria.
General characteristics of the diet. Sharp limitation of table salt (only 2-3 g contained in products), extractives, liquids (up to 800 ml of free liquid), increase in protein content (1.6 g/kg), mainly due to egg, milk and fish protein, full provision of the body's needs with minerals, vitamins and microelements, exclusion from the diet of substances, drinks and foods that irritate the kidneys (alcohol, nitrogenous extractives, cocoa, chocolate, spicy, salty snacks), inclusion of vegetable oils in the diet (1/3 of the total amount of fat), methionine and phosphatides, which have a lipotropic effect.
Chemical composition and calorie content of the diet. Proteins 125 g (of which 80 g are animal), fats 80 g (of which 25 g are of plant origin), carbohydrates 450 g (refined 50 g), table salt 2-3 g (in products). Calorie content 2900 kcal.
Vitamin content: retinol - 0.95 mg, carotene - 11.7 mg, thiamine - 0.7 mg, riboflavia - 1.1 mg, nicotinic acid - 17.5 mg, ascorbic acid - 100 mg. Mineral content: potassium - 3000 mg, calcium - 600 mg, magnesium - 285 mg, phosphorus - 1220 mg, iron - 21 mg.
Free liquid 800 ml. Diet weight 2.5 kg. The food temperature is normal, the number of meals is 5-6 times a day.
An approximate one-day menu for diet No. 7c is presented in table.
List of recommended products and dishes.
Bread and bakery products. Bran bread, wheat, white, salt-free.
Vegetarian soups with cereals, vegetables, fruits are prepared without salt.
Meat and poultry dishes. Low-fat varieties of beef, pork, lamb, chicken, turkey, rabbit, boiled or subsequently fried, in pieces or chopped.
Fish dishes. Low-fat fish (pike perch, perch, roach, pike, navaga, cod) boiled, chopped or in pieces.
Dishes and side dishes from cereals and pasta. Semolina, rice, wheat, buckwheat, pearl barley, etc. porridges with water, milk, crumbly; Krupeniki, puddings, zrazy, pilaf, cutlets.
Vegetable dishes and side dishes. Potatoes, carrots, beets, pumpkin, zucchini, cauliflower, tomatoes, cucumbers, lettuce, parsley. Boiled, baked, pureed, pureed.
Egg dishes. Bolkovy smelt and for preparing various dishes (more than 2 pieces per day).
Milk and dairy products and dishes made from them. Whole milk, kefir, yogurt, cottage cheese (low-fat) in its natural form, curd pudding, lazy dumplings.
Sauces and spices. White sauce, tomato sauce, marinade sauce, vegetable sauce. Sweet and sour vegetable and fruit sauces with the exception of meat, fish and mushroom broths. Prepared with water, milk, sour cream, cream.
Beverages. The tea is not strong. Raw fruit and vegetable juices. Rose hip decoction.
Fats. All kinds, with the exception of refractory ones (lamb, beef, pork).

Approximate one-day menu of diet No. 7b (2674 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Steamed omelette stuffed with meat	150	18,2	13,6	3,1
Krill paste marinated (without salt)	180	11,0	17,6	13,8
Tea with milk	200	1,4	1,7	2,25
Lunch
Prunes	50	0,9	-	32,8
Dinner
Vegetarian pearl barley soup with vegetables in vegetable oil (1/2 serving)	250	1,5	2,4	13,4
Meat balls baked in sour cream	110	20,9	14,9	16,8
Stewed carrots with prunes	190	3,3	13,5	38,6
Fresh apples	100	0,3	-	11,5
Afternoon snack
Rose hip decoction	100	-	-	-
Dinner
Stuffed fish	85/150	17,3	10,1	7,0
Steam pudding from low-fat cottage cheese	150	16,9	6,7	34,3
Tea without milk	100
For the night
Kefir	200	5,6	7,0	9,0
All day
White bread	100	7,9	1,9	52,7
Bran bread	150	14,7	7,2	54,5
Sugar	30	-	-	29,9
Total		120,0	96,8	319,4

Greenery. Parsley, dill, green onions, celery in salads and ready-made dishes.
Sweet dishes, sweets, fruits, berries, melons and vegetables. Any fruits and berries without limitation, raw or boiled. Watermelon, melon, pumpkin. Sugar is limited to 50 g (you can use honey instead - 70 g).
Excluded: turnip, radish, sorrel, spinach, garlic.

Therapeutic nutrition for phosphaturia

Phosphaturia is characterized by a violation of the acid-base balance towards alkalosis and the precipitation of poorly soluble calcium phosphate in the urinary tract. The development of phosphaturia is associated with a violation of the ratio of calcium and phosphorus in the urine as a result of an increase in the excretion of calcium in the urine and the loss of acidic valencies by the body. At the same time, with phosphaturia there is a complex chain of neurohumoral-renal disorders.
Sodium and potassium phosphates are soluble in urine, which is both acidic and alkaline; Calcium and magnesium phosphates are insoluble in alkaline urine.
Treatment for phosphaturia is aimed mainly at acidifying the urine and limiting foods rich in calcium. It is necessary to exclude from the diet spicy snacks, spices, alcohol that excite the nervous system, and substances that are an active stimulant of the secretory function of the stomach if phosphaturia is accompanied by gastric hypersecretion.
They recommend a diet with a limitation of dairy and vegetable foods and a predominance of meat foods, flour dishes, with a sufficient content of vitamins (A and D) and plenty of fluids. The diet can include weak tea without milk or weak coffee with a small amount of cream, bread, eggs and egg dishes in limited quantities, butter and vegetable oil, meat, fish soups, meat or fish in all types, flour dishes in all types ( with excess body weight are limited). Fish (non-spicy) snacks, not very salted herring, and canned fish in small quantities are allowed. Of greens and vegetables, you can only include in your diet those varieties that are low in calcium and alkaline valencies (peas, Brussels sprouts, asparagus, pumpkin). Berries and fruits are limited (lingonberries, red currants, sour apples are recommended); pastry products are allowed in small quantities.
Long-term restriction of calcium compounds in the diet negatively affects metabolism, therefore, against the background of the main “zigzag” diet, you can periodically include foods containing calcium (vegetables, fruits, herbs) in the diet.

Therapeutic nutrition for oxaluria

Oxaluria is the persistent excretion of calcium oxalate crystals in the urine. The disease is associated with a violation of the kidneys' secretion of protective coddoids, which maintain normal oxalic acid in a dissolved state. Calcium onsalates fall out at any urine pH, most often at 5.4-6.6.
When creating a diet for patients with oxaluria, it should be taken into account that the introduction of foods rich in oxalic acid with food increases the excretion of oxalates in the urine. Products with an excess content of oxalic acid and its salt are excluded from the diet: sorrel, spinach, beets, potatoes, beans, rhubarb, figs, parsley, some berries (plums, strawberries, gooseberries), tea, cocoa, coffee, chocolate. The source of oxalic acid formation can be gelatin due to its 16-19% glycol content.
Apples, pears, quince, pear tree leaves, grapes, black currants (in the form of a decoction) help remove oxalates from the body. Decoctions prepared on fruit peels increase the release of oxalic acid from the body.
The diet of a patient with oxaluria includes the following products: white and black bread, animal and vegetable butter, milk, cottage cheese, sour cream, eggs, sour dairy products, cheese, vegetarian soups (from permitted vegetables and fruits), milk soups, meat, fish and poultry boiled in limited quantities (150 g every other day), cereal and dough dishes, cauliflower and white cabbage, lentils, peas, green peas, turnips, asparagus, cucumbers, apples, pears, apricots, peaches, grapes, dogwoods, quince.
A patient with oxaluria is allowed to administer a sufficient amount of liquid (up to 2 liters) and juices of fresh vegetables and fruits. Table salt and carbohydrates are somewhat limited in the diet. For patients with oxaluria, diet No. 5 can be recommended with a restriction of carbohydrates to 300 g. During the period of exacerbation of the disease, it is necessary to limit the inclusion in the diet of milk and dairy products containing a significant amount of calcium.

10% of the world's population is diagnosed with some kind.

Very often, such diseases lead to disruption of the organ and the development of chronic renal failure.

The presence of predisposing factors and impaired renal function for three or more months allows doctors to suspect chronic renal failure.

This pathology is considered secondary, that is, it develops against the background of another disease.

General information about the disease

The kidneys perform many functions in the human body, and disruption of their function leads to disability and death.

Often, patients with chronic renal failure require lifelong therapy and permanent procedures that can replace the work of the kidneys.

The paired organ ensures water, nitrogen and electrolyte metabolism in humans. characterized by a violation of these exchanges, leading to an imbalance in the body. In addition, the kidneys:

• maintain a constant blood composition and fluid volume;
• remove toxins and metabolic products from the body;
• produce some biologically active compounds that are necessary for normal human life, these include renin, urodilatin, prostaglandins.

Normally, daily urine output should be about 75% of the volume of fluid drunk.

Causes

The causes of chronic renal failure can be divided into two types.

The first include diseases of the genitourinary system:

• chronic and;
• hereditary;

For the second, diseases not associated with primary kidney damage:

• diabetes;
• hypertonic disease;
• systemic diseases;
• viral hepatitis.

In all these diseases, kidney cells die. The dead are replaced by connective tissue.

At the beginning of the disease, the kidneys are able to perform their functions, but as the disease progresses, the organs cease to cope with them.

In the final stages of chronic renal failure, the patient develops heart failure, encephalopathy, and uremic coma. In this case, the person is indicated for a kidney transplant.

Stages of the disease

The main criterion for dividing by is the glomerular filtration rate. - this is the volume of primary urine that is formed in the kidneys per unit of time. Normal GFR is 80-120 ml/minute.

At the initial stage, there are no characteristic signs. Signs of the disease will depend on the causes and nature of the underlying disease.

Patients may experience pallor of the skin, a slight decrease in blood pressure and pulse.

Chronic renal failure is divided into 4 stages. This classification allows clinicians to select the necessary treatment tactics for each specific case.

Latent

Glomerular filtration rate 60 - 89 ml/min. The latent or latent form is so called because it has no specific symptoms. Its main manifestations are:

• increased fatigue;
• dry mouth;
• constant weakness.

But just because this phase doesn't have specific symptoms doesn't mean it can't be diagnosed. Blood and urine tests may indicate:

• changes in phosphorus-calcium metabolism;
• disaminoaciduria;
• decreased secretory activity of tubules;
• increased excretion of sugars;

Compensated

GFR 30-59 ml/min. Here, the symptoms indicated in the latent stage become permanent. One of the main signs is an increase in the volume of daily urine to 2.5 liters or more.

Intermittent

GFR 15 – 30 ml/min. It is characterized by the complete disappearance of all signs of the disease, and then their reappearance. In addition to the above symptoms:

• yellowness of the skin;
• the skin loses its elasticity and becomes dry;
• muscle tone weakens;
• pain appears in the joints and bones.

Terminal

Is irreversible. The kidneys practically do not perform their functions, and other internal organs are damaged. The main symptom is a decrease in diuresis, up to the complete disappearance of urine. GFR 15 - 5 ml/min. Other signs include:

• emotional stability;
• insomnia;
• hoarse voice;
• smell of ammonia from the mouth;
• smell of urine from the patient.

Indications for diet

Dietary nutrition is prescribed to patients with chronic kidney disease, edema and impaired metabolism.

For kidney diseases, patients are prescribed diet No. 7. It has several variations: 7A, 7B, 7B, 7D, 7p.

The main criterion for the difference between these diets is the amount of protein, namely:

For hemodialysis patients, the protein norm increases to 1.6 g per kg of the patient's ideal weight. In other words, this is 110 - 120 g of protein in the daily menu. In severe cases of the disease, some patients are allowed only 70 g per day during hemodialysis.

General principles of nutrition

Nutritionists have developed special rules, following which, a patient with chronic renal failure will be able to improve his condition. Here are the main ones:

• the patient must eat at least 3500 kcal per day;
• meals should be divided, in small portions (4 - 6 times a day);
• limiting table salt to 3 grams per day; in the presence of high blood pressure and edema, it is possible to completely eliminate salt from the diet;
• reducing the amount of protein to 20 - 70 g per day;
• the diet must include fruits and vegetables;
• limit fluid to 1 liter per day.

Main menu

The indicated menu is an approximate version of what a patient with chronic renal failure can eat. All dishes in this version are salt-free.

In the absence of edema and high blood pressure, the patient is allowed a small amount of salt. Consumption rates are individual and are discussed with each patient separately.

Breakfast: rice porridge, salt-free bread, tea.

Afternoon snack: baked apples.

Dinner: vegetarian borscht, boiled meat with buckwheat, salt-free bread, dried fruit compote.

Vegetarian borscht recipe. Ingredients: beets, fresh cabbage, potatoes, onions, tomatoes. Cooking methods:

• Place whole beets in boiling water and cook until half cooked;
• the vegetable must be removed and grated after cooling;
• stew tomatoes, onions and carrots in a frying pan with vegetable oil;
• cut the potatoes into cubes and put them in the water in which the beets were boiled;
• after 15 minutes, send the cabbage there, after another 15 minutes, stewed vegetables;

Dinner: salad with chicken liver, cod with steamed vegetables, salt-free bread, tea.

Chicken liver salad recipe. Ingredients: chicken liver 6 pieces, potatoes 4 pieces, onion, vegetable oil, salt. Cooking method:

• Cut the fried liver and boiled potatoes into cubes, add onion and vegetable oil.

Recipe for cod with steamed vegetables. Ingredients: 0.5 kg cod, vegetables, lettuce. Cooking method:

• Place foil on the bottom of the steamer to retain the juice from vegetables and fish;
• put vegetables that you have in the house: potatoes, onions, beets, carrots; frozen vegetables are suitable: broccoli, beans or Brussels sprouts;
• Place cod pieces on top of the vegetables and wrap the edges of the foil inward, but not tightly, turn on the steamer for 20-30 minutes.

Second dinner: any fruit.

Let us consider in more detail which of the diets of the seventh table is necessary for use in chronic renal failure and the rapid recovery of the patient.

Menu and diet for 1 form

When a diagnosis is made, at the initial stage, the patient is prescribed diet No. 7. Bread should be protein-free. The total daily amount of protein should not exceed 60 g, but this amount may be reduced depending on the general condition of the patient.

At this stage, fluid intake is not limited.

The patient is allowed to drink this amount the next day.

Up to 5 g of salt is allowed, provided that the patient does not have edema or high blood pressure.

At the second stage

In case of stage 2 chronic renal failure, the patient is advised to constantly adhere to diet No. 7B. With this diet, in addition to protein, it is necessary to reduce the amount of phosphorus in food. The patient is prohibited from eating:

• egg yolk;
• poultry meat;
• nuts;
• legumes;
• dairy products.

Meat, fish, fish, rice and potatoes contain large amounts of phosphorus. To reduce its amount, it is recommended to boil these products twice in large amounts of water.

With this manipulation, phosphates in them are reduced by 2 times. Also, with this diet, the patient is prescribed the drug Ketosteril. It helps bind phosphates and remove them from the intestines.

On the third

For stage 3 chronic renal failure, you are allowed to eat no more than 25 g of protein per day, preferably of animal origin.

Depending on the patient's general condition, he may be allowed to switch to Diet 7A, but will still need to return to Diet 7B several times a week.

Diet for the fourth

In the terminal stage, when the patient is on hemodialysis, he needs proper nutrition.

The amount of protein increases, since after hemodialysis a person loses many important substances in the body.

On average, a patient should eat about 450 g of carbohydrates and 90 g of protein. In addition, he is prescribed medications containing amino acids.

The amount of fluid depends on the patient's diuresis. Decreased diuresis means fluid restriction. Salt intake depends on the presence of edema and arterial hypertension.

Food for chronic renal failure must first be boiled, and then stewed or baked.

Food restrictions

For any degree of chronic renal failure, the patient is contraindicated:

• all salty, pickled and fermented dishes;
• fatty meat and fish broths;
• mushrooms in any form;
• chocolate;
• sauces and snacks;
• canned sausages and smoked meats.

Conclusion

Nutrition plays a very important role in chronic renal failure. Along with drug treatment, diet helps prolong a person’s full life and delay the onset of irreversible processes in the body.

The course of the disease and its progression will depend directly on how the patient behaves.

By following all the doctors' orders and following their recommendations, a person can live a long life.