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Dietary Principle of Restricted Phosphorus and Potassium 限制低磷鉀飲食原則

2016-12-14
Goal:

For early renal dysfunction, appropriate restrictions on the content of phosphorus and potassium in diet could slow down the decline of renal function. Excessive phosphorus could incur reduced calcium and eventually leading to pathological changes of bones, and skin lesions and pruritus. If there is high potassium in patients, they could suffer from arrhythmia, cardiopulmonary failure, or even death. Dialysis patients with hyperphosphatemia and high potassium should be aware of the intake of phosphorus and potassium.

Dietary guidelines for subjects with:
  1. Renal dysfunction
  2. Acute or chronic renal failure
  3. Dialysis
  4. Hyperphosphatemia syndrome
  5. Hyperkalemia
General principle:
  1. Getting to know high-phosphorus food
    (1) Foods containing yeast: Yakult, yoguart, cheese, Jian Su-sugar, yeast 
    (2) Dry beans: green, red beans, and black beans. 
    (3) Whole grains: brown rice, Adlay, dried lotus seeds, whole-wheat products, and wheat germ.
    (4) Visceral categories: pork heart, liver, and chicken gizzards. 
    (5) Nuts: peanuts, melon seeds, walnuts, cashews, chestnuts, pistachios, and almonds.
    (6) Others: cola, soft drinks, cocoa, egg, dried meat floss, black sesame, and lecithin
  2. If phosphorus is low, discuss the condition with your dieticians or physicians for there could be inadequate intake of protein in your diet. 
  3. The use of phosphate binders:
    (1) Kidney patients should avoid consuming food containing phosphorus and use phosphate binders appropriately in order to reduce intestinal absorption of phosphorus. 
    (2) There are three commonly used phosphate binders: calcium carbonate , calcium acetate and aluminum hydroxide, which is commonly known as stomach milk tablets. 
    (3) Purchase stomach milk tablets from nearby pharmacies in case of emergency. 
    (4) To reduce intestinal absorption of phosphorus, chew those calcium carbonate tablets or stomach milk tablets and mix them with rice and vegetables. When it comes to calcium acetates, do not chew them; simply mix them with rice and beans, fish, and meat. 
  4. Tips for reducing potassium intake: since potassium is soluble in water, it is generally stored in a variety of foods; thus, be aware of the following intake principles:  
    (1) Vegetable: rinse it and cut it into small pieces; boil it with hot water; take it out of water and fried it. Avoid vegetable soup, energy soup, and lettuce. 
    (2) Fruit:  avoid drinking fruit juice and eating dry fruit.
    (3) Meat: avoid mixing rice with thick gravy broth. 
    (4) Beverages: avoid drinking strong black coffee, strong tea, chicken essence, sports drinks, and other beverages. Tap-water and mineral water are top drinking options; drinking appropriate amount of light coffee and tea is all right. 
    (5) Condiments: Do not use low-sodium, healthy delicious salt, thin salt, and soy sauce without sodium.
  5. Patients with constipation should exercise more and develop a good habit of regular bowel movement.

Low potassium fruit appropriate for patients with chronic renal failure:

Fruit

Each fruit weight (grams)

Potassium content per fruit (mg)

Pineapple

125 g(1 bowl of peeled pineapple) 

36

Mangosteen

90 g (approximate 5 mangosteen)

54

Mango

150 g (1 small mango before skin is peeled.)

80

Apple

125 g (1 small apple before skin is peeled) \

100

Persimmon

75 g (1 small persimmon before skin is peeled)

105

Grape

100 g (about 13 grapes)

120

Passion fruit

130 g (about 1.5 passion fruit)

120

Small jade water-melon

210 g (pulp weighs heavy, about 1 and 1/4 bowl)

126

Pomelo

115 g (about 3 slices after skinned)

127

Honey peach

145 g (1 peach before the skin is peeled)

135

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