Why is good nutrition vital for kidney failure patients?

Eating healthy is important to us all but it is even more important if your kidneys are failing. In chronic kidney disease good nutrition and diet are critical components of the treatment plan. The recommended diet, which includes protein, calories and nutrients, depends upon how much kidney function you have. Vitamins and minerals, which come from food, are essential for making energy, promoting growth and repairing tissues. However, since the kidney diet limits some food groups, people with kidney disease may not be getting all the necessary vitamins and minerals they need. Thus it becomes very important that a kidney failure patient consumes good and right amount of nutrients.

Do I need to change my diet if I have kidney failure?

What you eat has a major impact on the health of your kidneys. Protein, sodium, fluids, and certain minerals are especially important. When you have chronic kidney disease your kidneys are no longer working as well as they need to. Changing your diet can help protect your kidneys. It can also help you in preventing your kidney disease from worsening.

What are the basics of good nutrition?

Key nutrients of healthy diet are:

• Protein
• Carbohydrates
• Vitamins
• Minerals

You will need a diet that gives you the right amounts of protein, carbohydrates, vitamins and minerals each day. This will help you to stay healthy.

Why do I need protein?

Protein is an important nutrient.Your body needs protein to help build muscle, repair tissue and fight infection. Before you started dialysis you may have needed to be on a limited protein diet to prevent wastes from building up in your blood. But patients on dialysis need higher amount of proteins because of less intake, more demand and loss during dialysis. Getting the right amount of protein is important to your overall health and how well you feel.

What are the different sources of dietary protein?

Proteins are derived from the following:

Animal sources - e.g., chicken, fish, turkey, lean meat, duck, lamb, fresh pork, eggs and milk products

Plant sources - e.g., grains, fruits and vegetables, which are not as well utilized by the body as are the animal sources listed above, but are still necessary in the diet.

What are proteins and their role in the body?

Proteins are complex organic compounds and are made up of a chain of amino acids.

Proteins – which may be in the form of enzymes, hormones and antibodies – play the following role in the body:

• Helps with growth and maintenance of body tissue and prevents loss of muscle mass.
• Fights infection, enables healing of wounds and it provides a source of energy to the body.
• Involved in the transport of cholesterol and fat-soluble vitamins and help keep osmotic balance among body fluids.
  

What are high and low quality proteins?

Proteins that have all the essential amino acids and are utilized completely by the body are called complete or high quality proteins. All meat and other animal products are sources of complete proteins. These include beef, lamb, pork, poultry, fish, fish, eggs, milk, and milk products. Plant proteins can be combined to include all of the essential amino acids and form a complete protein. Examples of combined, complete plant proteins are rice and beans, milk and wheat cereal, corn and beans.

Proteins that do not contain all the essential amino acids and are not completely utilized by the body are called incomplete or low quality proteins. Proteins in foods (such as grains, fruits, and vegetables) are either low, incomplete protein or lack one of the essential amino acids. These food sources are considered incomplete proteins.

What are amino acid and the types of amino acids?   

Amino acids are the basic building blocks of proteins. Fundamentally, amino acids are joined together by peptide bonds to form the basic structure of proteins. The human body requires approximately 20 amino acids for the synthesis of its proteins.

Two types of amino acids:

Essential - These amino acids cannot be synthesized by our body and therefore must be supplied through diet.
E.g.: phenylalanine, valine, threonine, tryptophan, isoleucine, methionine, leucine, and lysine.

Non- essential - These amino acids that be synthesized in the body and therefore are not dietary essentials. Nonessential amino acids are made by the body from the essential amino acids or normal breakdown of proteins.
E.g.: arginine, alanine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, proline, serine, and tyrosine.

Why does malnutrition occur in dialysis patients?

Dialysis patients experience loss of appetite, nausea and anorexia leading to inadequate dietary intake of protein. Also intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses during dialysis could lead to malnutrition.

What are the consequences of poor nutrition in dialysis patients?

Poor malnutrition especially inadequate protein intake in dialysis patients if not corrected leads to poor immunity to fight infection, tiredness, fatigue, loss of interest in routine work. It is been also found that malnutrition will increase the chance of cardiovascular disease.

How does one correct protein malnutrition in dialysis patients?

Your doctor will recommend you an ideal food that suits you or will refer you to a dietician for diet recommendation.

What is recommended for protein intake in dialysis patients?

The World body on Kidney Diseases called KDOQI recommends a minimum of 1.2 in hemodialysis and 1.3 g of proteins/kg BW in Peritoneal Dialysis patients. Out of that, 50 percent or more should come from high quality animal sources.

Do I get adequate proteins through my diet?

If your food intake is good and if you take high biological proteins, it will suffice the protein requirements of dialysis patients.

Are there any protein supplements that provide high quality proteins along with other vital ingredients?

Yes; Biocon has launched a high quality protein called Whey proteins along with vital minerals and vitamins to patients who require protein supplements.

What is Whey Protein?

Whey protein is the collection of globular proteins isolated from whey, a by-product of cheese manufactured from cow's milk. It is typically a mixture of beta-lactoglobulin (~65%), alpha-lactalbumin (~25%), and serum albumin (~8%), which are soluble in their native forms independent of pH.

How does whey protein qualify as a high quality protein?

Whey protein is a high source of branched chain amino acids (BCAAs) and essential amino acids having a PDCAAS value of 1, therefore it qualifies as high quality protein.

What is PDCAAS?

The protein digestibility-corrected amino acid score (PDCAAS) has been adopted by FAO/ WHO as the preferred method for the measurement of the protein value in human nutrition. The method is based on comparison of the concentration of the first limiting essential amino acid in the test protein with the concentration of that amino acid in a reference (scoring) pattern. This scoring pattern is derived from the essential amino acid requirements of the preschool-age child. The chemical score obtained in this way is corrected for true fecal digestibility of the test protein.

Proteins with PDCAAS values exceeding 100% were not considered to contribute additional benefit in humans and were truncated to 100%.

What are PDCAAS values for different dietary proteins?

A PDCAAS value of 1 is the highest and 0 the lowest as the table demonstrates the ratings of commons foods below.

What are the minerals present in NARITA +
NARITA + is forified with following minerals which are vital for our body. Eg; Sodium, potassium, magnesium, chloride, phosphorus, Chromium, iron, fluoride, iodine,  copper, manganese, molybdenum, selenium and zinc

Why Electrolytes like Sodium and Potassium are kept low in NARITA +
Dietary intake of sodium and water are interrelated. They increase the risk of water retention, volume overload and electrolyte imbalance. This may worsen  hypertension and congestive heart failure. So the sodium intake in HD patients is restricted to 2g/day

What are trace elements and their role in the body
Trace elements are inorganic elements present/ required by the body in minute quantities which have a vital role.

Role of Trace elements

• cofactors or catalysts of enzyme activity
•  maintenance of normal tissue functions
• help in cell metabolism

What are the Vitamins present in NARITA +

NARITA+ contains the following Vitamins which are vital for cellular function and metabolism.

Fat soluble vitamins :

• Vitamin A
• Vitamin D
• Vitamin E
• Vitamin K

Water soluble vitamins:

• Vitamin B1
• Vitamin B2
• Vitamin B6
• Vitamin B12
• Niacin
• Folic acid
• Biotin
• Pantothenic acid
• Choline
• Vitamin C