September 25, 2022

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Kidney patients can take more protein if high urine protein?

Kidney patients can take more protein if high urine protein?

 

Kidney patients can take more protein if high urine protein?  High urine protein is one of the main manifestations of kidney disease.  In order to protect the kidney, the four conditions are different!

Kidney patients can take more protein if high urine protein?

High urine protein is one of the main manifestations of kidney disease. In routine urine examinations, urine protein exceeding the standard can be shown as urine protein 1+, 2+ or 3+; in the 24-hour urine protein quantitative examination, urine protein exceeding the standard can be distinguished as a small amount of 0.3-1.0 grams of proteinuria, 1.0-3.5 Grams of moderate proteinuria and greater than 3.5 grams of large proteinuria. As long as the urine protein of patients with kidney disease exceeds the standard of 1+ or the 24-hour urine protein quantitative is greater than 0.3 grams, it is usually high in urine protein (over the normal range).


Because protein is one of the three major nutrients of the human body, high urine protein is equivalent to the loss of protein nutrients from the urine of patients with kidney disease. The higher the amount of urine protein, the more nutrients are lost from the urine. In general, nephrotic syndrome loses more protein from urine than other kidney diseases. One of the reasons for the low plasma albumin of patients is related to large amounts of proteinuria.

Although the urine protein of other kidney diseases is not so high and the plasma albumin is not necessarily significantly reduced, but it continues to leak nutrients from the urine. The harm of protein leakage from urine is not only the loss of nutrients, but it also leads to further damage to the kidneys and the progressive development of nephropathy, which ultimately affects renal function and leads to chronic renal failure.


So the question is, can patients with kidney disease who have high urine protein get more protein from their diet? This requires specific treatment of specific conditions, divided into the following four situations.

1. Patients with nephrotic syndrome

The main manifestation of nephrotic syndrome is the loss of a large amount of protein in the urine and a significant decrease in plasma albumin. The patient’s 24-hour urine protein quantification is above 3.5 grams, and some even exceed 5.0 grams or 8.0 grams; while the patient’s plasma albumin will be less than 30g/L, and some even as low as 20g/L or 15g/L.

The protein content of a medium-sized egg is about 7.0 grams. That is to say, the protein lost from urine in patients with nephrotic syndrome is equivalent to half to a standard-sized egg. It can be said that the protein leaked from urine is a lot of.

If you lose this protein in your urine, you should of course get it from your diet, otherwise the patient’s malnutrition will become more serious. Under normal circumstances, the protein intake of patients with kidney disease with normal renal function and urine protein should be calculated at 1.0-1.2 grams per kilogram of body weight per day. For a patient weighing 60 kg, the total protein intake per day should be 60-72 grams.

For patients with nephrotic syndrome who have a large amount of proteinuria, the amount of protein consumed daily should be added to the amount of protein lost from the urine. If a patient with nephrotic syndrome weighing 60 kg has a 24-hour urine protein quantitative of 5.0 grams, the amount of protein supplemented per day should be 65-77 grams (that is, about 70 grams). In other words, nephrotic syndrome patients with particularly high urine protein should supplement a little more protein from their diet.

So, is the more supplement the better? Of course not. When the patient consumes too much protein, not only can it not completely replenish the lost protein, but it will cause more protein to leak in the urine (higher urine protein), and it will also damage the kidney. That is to say, on the basis of the treatment of the primary disease, the diet can only be supplemented with protein appropriately. In this way, it can not only supplement nutrition, but also protect the kidneys.

 

2. Nephropathy patients with high urine protein

Except for nephrotic syndrome with large proteinuria, the urine protein of other kidney diseases is not very high, that is, the level of small proteinuria and moderate proteinuria. In nephropathy with high urine protein, the patient’s renal function is normal, that is, it has not progressed to chronic renal failure or complicated with acute kidney injury.

For patients with this type of kidney disease, generally speaking, there is no need to add too much protein from the diet, that is, calculate how much protein should be taken according to 1.0-1.2 grams per kilogram of body weight per day. There is no need to over-limit the protein quality in the diet, and at the same time not to consume too much protein. This is because long-term excessive restriction can cause malnutrition, and long-term intake of too much can affect kidney function, which is not desirable.


3. Patients with acute or chronic renal failure

For acute or chronic renal failure with high urine protein, the daily protein intake of the patient from the diet is different from the two situations where the renal function is completely normal, that is, not only cannot supplement protein from the diet, but should supplement less protein. According to the severity of kidney failure, the amount of protein intake will be reduced to varying degrees.

Generally speaking, the total protein intake per day should be calculated at 0.5-1.0 grams per kilogram of body weight per day. The higher the serum creatinine or the lower the glomerular filtration rate, the lower the protein intake. The purpose of such dietary restriction is to protect the residual renal function and continue the progression of renal failure.

 

4. Nephropathy patients with malnutrition

Patients with chronic kidney disease have been suffering from chronic kidney disease for a long time. Due to insufficient intake (excessive taboos), malabsorption, or excessive consumption, the patient will have malnutrition, which is manifested as weight loss (except for combined malignant tumors, hyperthyroidism, and diabetes ) And low plasma albumin (different from low plasma albumin in nephrotic syndrome).

The harm of chronic kidney disease combined with malnutrition is not only the decline of the patient’s resistance, but also the accelerated progression of kidney disease to renal failure and uremia. Therefore, patients with kidney disease who have not yet experienced malnutrition should avoid excessive taboos to prevent malnutrition; patients with kidney disease who have already experienced malnutrition need to increase the total intake of protein in the diet and ensure that the amount of high-quality protein is not enough. Less than 60%.

High-quality protein includes eggs, fresh milk, freshwater fish and animal lean meats, etc., while ensuring the balance of other nutrients (such as vitamins, minerals and trace elements).

Therefore, even if the patient’s urine protein is high, it does not mean that more protein can be added to the daily diet. In order to protect our kidneys, the above four conditions require different protein supplements.

 

(source:internet, reference only)


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