Abinci a cikin cututtukan koda

Daga ra'ayi na asibiti, cutar koda na iya zama yanayin haɓaka da sauri da kuma yada cutar kumburi wanda ke haifar da gazawar koda, ko kuma yana iya zama tsari mai ci gaba tun daga farko yayin da kumburi na kullum a hankali kuma ba zai iya jurewa ba.

Daga ra'ayi na abinci, yana da mahimmanci don ba da ruwa, gishiri, potassium da furotin a cikin cututtukan koda. Lokacin shirya abinci, nauyin jiki, ma'aunin ruwa da tattarawar electrolytes a cikin jini ya kamata a yi la'akari da su. A cikin m gazawar koda, musamman tare da hauhawar jini na urea, ana ba da shawarar rage cin abinci mai ƙarancin furotin, tare da samar da makamashi mafi dacewa 30-50 kcal / 1 kg na nauyin jiki, idan cutar ba ta da rikitarwa. Ya kamata ku ware nama, yankan sanyi, cuku, ƙwai daga abinci, iyakance madara da abinci mai arzikin potassium da phosphorus. Har ila yau, ƙuntatawa ya shafi samar da gishiri da ruwa. Banda shi ne matakin farkon polyuria tare da shawarar shan ruwa mai yawa. An ba da shawarar cin abinci mai raɗaɗi tare da ƙari na rusks, ƙananan furotin gari na alkama, dafaffen 'ya'yan itace puree, compotes mashed, dankali mai dankali tare da man shanu ana bada shawarar. Ana ba da shawarar mai ya zama 1g / 1 kg na nauyin jiki. A cikin matsanancin gazawar koda, ana iya kula da marasa lafiya ta hanyar kiyayewa ko kuma tare da dialysis. Yayin da kuke murmurewa, kun canza zuwa tsarin abinci mai gina jiki, sannu a hankali ƙara adadin ruwa da samfuran furotin.

A cikin gazawar koda na yau da kullun, hoton asibiti ya dogara da tsananin rashin lafiyar koda. Shawarwari na abinci a cikin wannan lokacin za a iya raba zuwa 4 lokaci: 0,6st lokaci - latent gazawar, inda babu ƙuntatawa na abinci, 0,8nd lokaci - ramuwa kasawa, akwai raguwa na gina jiki 1-0,4 g / 0,6. 1 kilogiram na nauyin jiki, phosphorus, gishiri, Lokacin III - rashin wadatarwa, wanda aka yi amfani da ƙarancin furotin na 20-25 g / 15 kg na nauyin jiki, low-sodium, low-potassium rage cin abinci, ya kamata sau da yawa. wadatar da babban kalori, ƙananan shirye-shiryen furotin, lokacin IV - gazawar ƙarshen matakin, wanda furotin da aka samar shine 20-XNUMX g / rana ko dialysis, iyakance sodium, potassium, phosphorus da ruwaye, ana buƙatar ƙara amino acid mai mahimmanci. acid XNUMX-XNUMX g / rana zuwa jita-jita, misali Ketosteril.

Gabaɗaya ka'idodin abinci a cikin jiyya na mazan jiya: Bukatar makamashi a cikin marasa lafiya tare da nauyin jiki na yau da kullun sama da shekaru 60 ya kamata su ba da 35 kcal / 1 kg na nauyin jiki / rana, kuma a cikin marasa lafiya a ƙarƙashin shekaru 60. Ya kamata ya ba da 30-35 kcal / 1 kg na nauyin jiki / rana, watau game da 2000-2500 kcal / rana. A cikin marasa lafiya marasa aiki, isasshen abinci shine 1800-2000 kcal / rana. Ƙayyadaddun furotin yana jinkirta jiyya na dialysis, adadin furotin yana ƙayyade ta hanyar tattarawar urea da creatinine a cikin jini na jini da izinin creatine (GFR). Mafi ƙarancin abun ciki na furotin a cikin abinci shine 20 g / rana tare da ƙarin mahimman amino acid. Ana iya samun irin wannan iyakance ta amfani da abincin dankalin turawa a cikin adadin 1 kg na dankali + 300 g kayan lambu da 'ya'yan itace + 120 g na sabo ne man shanu da mai + 50 g na sukari da ƙari na dankalin turawa, ko sitaci maras gina jiki. gari tare da sabo ko busassun kayan yaji, ba tare da gishiri ba. Dabarun shirya jita-jita na dankalin turawa shine dafa abinci, yin burodi, yayin da ba a cire frying a cikin yanayin rashin lafiyar mai. Jita-jita da za a iya shirya su ne noodles, dumplings, dumplings, casseroles, cushe dankali, salads. Matsakaicin iyakar furotin shine 40-50 g / rana kuma ƙaramin iyaka shine 60-70 g / rana. Protein ya kamata ya kasance mai kyau, daga kayan dabba: nama maras kyau, madara mai madara, cuku gida, farin kwai, kefir, yoghurt. wadatar mai baya buƙatar iyakance 1 g / 1 kg na nauyin jiki. Ya kamata ya fito daga kayan shuka, watau man zaitun, man waken soya, man sunflower, man rapeseed. Contraindicated mai kayayyakin na dabba asalin su ne: man alade, tallow, m margarine, naman alade, kazalika da m nama irin su naman naman naman, naman alade, offal, duck, Goose, m kifi, rawaya da sarrafa cuku, naman alade, pates, tsiran alade. Hakazalika, kayan daɗaɗɗen da ke ɗauke da kitse mai yawa, irin su busassun da biredi, ba su da kyau. Ƙuntataccen ruwa ya dogara da edema, hauhawar jini da adadin fitsarin da aka fitar yayin rana. Ya kamata ku kula da abun ciki na ruwa a cikin samfurori, misali miya, kayan lambu, 'ya'yan itace, samar da matsakaicin 400-500 ml. iyakance sodium a cikin lokacin rashi rashi ba a buƙata ba, amma ana bada shawarar iyakance zuwa 3 g (1 teaspoon) na gishiri a kowace rana a matsayin ma'aunin rigakafi, saboda yawan cin abinci mai yawa. Ya isa ba don ƙara gishiri a cikin jita-jita ba, ware samfuran gishiri a cikin tsarin fasaha, kamar: abincin gwangwani, pickles, nama mai sanyi, nama mai sarrafa, cuku mai kyafaffen, cuku mai rawaya, silage, mai da hankali na miya da miya, shirye-shirye. kayan yaji, misali kayan lambu, kayan lambu, cubes na broth. rage sinadarin phosphorus daga kayayyakin da ke da sinadarin phosphorus, kamar su: offal, kayayyakin hatsi, rennet da cuku mai sarrafa su, tsaban legume, kifi, gwaiduwa kwai, namomin kaza, tsiran alade, madarar foda.

Hakanan ana ba da shawarar cin shirye-shiryen da ke ɗaure phosphate a cikin sashin narkewar abinci yayin abinci. Ya kamata a ƙara buƙatar potassium a cikin lokacin rashi ramuwa, kuma a cikin ƙarshen ƙarshen matakin ya kamata a iyakance zuwa 1500-2000 mg / rana, ban da samfuran da ke cikin wannan ma'adinai: busassun legumes, bran, koko, cakulan , kwayoyi, busassun 'ya'yan itace, ayaba , avocados, tumatir, dankali, kayan lambu masu ganye, namomin kaza. Ana iya rage potassium ta hanyar jiƙa da dafa abinci, tare da canza ruwa yayin dafa abinci. buƙatar sauran ma'adanai yakamata su ƙara ƙarancin calcium, saboda ƙarancin samfuran furotin, ƙarin ƙarancin ƙarfe wanda ke haifar da anemia. bukatar bitamin kari bitamin rashi. daga rukunin B, folic acid, vit. C da D saboda ƙarancin abinci na potassium.

Gabaɗaya ka'idodin abinci yayin lokacin dialysis: buƙatar kuzari saboda rashin abinci mai gina jiki akai-akai na marasa lafiya da ke fama da cutar ya zama 35-40 kcal / 1 kg na nauyin jiki, watau 2000-2500 kcal / rana. Babban tushen carbohydrates yakamata ya zama samfuran hatsi: taliya, groats, gari sitaci, burodin sitaci mara ƙarancin furotin. A cikin marasa lafiya da aka yi wa dialysis na peritoneal, wannan buƙatu an rufe shi da wani yanki da glucose a cikin ruwan dialysis. Bukatar furotin saboda asarar yayin dialysis shine 1,2-1,4 g / 1 kg nauyin jiki a cikin marasa lafiya na hemodialysed, da 1,2-1,5 g / 1 kg nauyin jiki a cikin peritoneal dialysis, watau 75-110 g / rana. Za a iya wadatar da abincin da furotin daga abubuwan gina jiki, misali Protifar. Bukatar kitse a cikin dialysis na waje yakamata ya zama kashi 30-35% na kuzari, kuma a cikin dialysis na peritoneal 35-40%. makamashi da ake samu daga kayan shuka, galibi man zaitun da mai. Bukatar potassium yakamata a iyakance zuwa 1500-2000 MG / rana, kada a yi amfani da hannun jari da nama. Bukatar phosphorus yakamata ya iyakance yawan amfani da kayan da ke cikin wannan bangaren da kuma amfani da magungunan da ke daure phosphate a cikin hanji. ƙuntatawa na sodium ya shafi. Bukatar ma'adanai da bitamin na buƙatar kari na alli, vit. D, A da C. ƙuntatawar ruwa da aka ƙididdige yawan adadin fitsari + 500 ml, adadin da aka ƙara yana nuna kawai a cikin yanayin zafi, zazzabi mai zafi, amai da zawo.

Source: Shugaban da Sashen Nephrology, Hawan jini da Cututtukan Ciki, Collegium Medicum im. L. Rydygier in Bydgoszcz

1. I period - latent gazawar, inda babu ƙuntatawa na abinci,
2. Lokacin IV - gazawar mataki na ƙarshe, wanda wadatar furotin shine 20-25 g / rana ko dialysis, iyakancewar sodium, potassium, phosphorus da ruwaye, ana buƙatar ƙara mahimman amino acid 15-20 g / rana. jita-jita, misali Ketosteril.
3. Ƙayyadaddun furotin yana jinkirta jiyya na dialysis, adadin furotin yana ƙayyade ta hanyar tattarawar urea da creatinine a cikin jini na jini da izinin creatine (GFR). Mafi ƙarancin abun ciki na furotin a cikin abinci shine 20 g / rana tare da ƙarin mahimman amino acid. Ana iya samun irin wannan iyakance ta amfani da abincin dankalin turawa a cikin adadin 1 kg na dankali + 300 g kayan lambu da 'ya'yan itace + 120 g na sabo ne man shanu da mai + 50 g na sukari da ƙari na dankalin turawa, ko sitaci maras gina jiki. gari tare da sabo ko busassun kayan yaji, ba tare da gishiri ba. Dabarun shirya jita-jita na dankalin turawa shine dafa abinci, yin burodi, yayin da ba a cire frying a cikin yanayin rashin lafiyar mai. Jita-jita da za a iya shirya su ne noodles, dumplings, dumplings, casseroles, cushe dankali, salads. Matsakaicin iyakar furotin shine 40-50 g / rana kuma ƙaramin iyaka shine 60-70 g / rana. Protein ya kamata ya kasance mai kyau, daga kayan dabba: nama maras kyau, madara mai madara, cuku gida, farin kwai, kefir, yoghurt.
4. Ƙuntataccen ruwa ya dogara da edema, hauhawar jini da adadin fitsarin da aka fitar yayin rana. Ya kamata ku kula da abun ciki na ruwa a cikin samfurori, misali miya, kayan lambu, 'ya'yan itace, samar da matsakaicin 400-500 ml.
5. iyakance sodium a cikin lokacin rashi rashi ba a buƙata ba, amma ana bada shawarar iyakance zuwa 3 g (1 teaspoon) na gishiri a kowace rana a matsayin ma'aunin rigakafi, saboda yawan cin abinci mai yawa. Ya isa ba don ƙara gishiri a cikin jita-jita ba, ware samfuran gishiri a cikin tsarin fasaha, kamar: abincin gwangwani, pickles, nama, nama mai sarrafa, kyafaffen, cuku mai rawaya, silage, mai da hankali na miya da miya, kayan yaji da aka shirya, misali kayan lambu, kayan lambu, cubes na broth.
6. rage sinadarin phosphorus daga kayayyakin da ke da sinadarin phosphorus, irin su: offal, kayayyakin hatsi, rennet da cuku mai sarrafa su, tsaban legume, kifi, gwaiduwa kwai, namomin kaza, yankan sanyi, madarar madara. Hakanan ana ba da shawarar cin shirye-shiryen da ke ɗaure phosphate a cikin sashin narkewar abinci yayin abinci.
7. Ya kamata a ƙara buƙatar potassium a cikin lokacin rashi ramuwa, kuma a cikin ƙarshen ƙarshen matakin ya kamata a iyakance zuwa 1500-2000 mg / rana, ban da samfuran da ke cikin wannan ma'adinai: busassun legumes, bran, koko, cakulan , kwayoyi, busassun 'ya'yan itace, ayaba , avocados, tumatir, dankali, kayan lambu masu ganye, namomin kaza. Ana iya rage potassium ta hanyar jiƙa da dafa abinci, tare da canza ruwa yayin dafa abinci.
8. buƙatar sauran ma'adanai yakamata su ƙara ƙarancin calcium, saboda ƙarancin samfuran furotin, ƙarin ƙarancin ƙarfe wanda ke haifar da anemia.
9. bukatar bitamin kari bitamin rashi. daga rukunin B, folic acid, vit. C da D saboda ƙarancin abinci na potassium.
10. Bukatar kitse a cikin dialysis na waje yakamata ya zama kashi 30-35% na kuzari, kuma a cikin dialysis na peritoneal 35-40%. makamashi da ake samu daga kayan shuka, galibi man zaitun da mai.
11. Bukatar potassium yakamata a iyakance zuwa 1500-2000 MG / rana, kada a yi amfani da hannun jari da nama.
12. Bukatar phosphorus yakamata ya iyakance yawan amfani da kayan da ke cikin wannan bangaren da kuma amfani da magungunan da ke daure phosphate a cikin hanji.
13. ƙuntatawa na sodium ya shafi.
14. Bukatar ma'adanai da bitamin na buƙatar kari na alli, vit. D, A da C.
15. Ana ƙididdige ƙayyadaddun ruwa daga adadin fitowar fitsari + 500 ml, ƙarin adadin ana nuna shi kawai a yanayin zafi, zazzabi mai zafi, amai da gudawa.

Wasu ganye suna tallafawa magani da rigakafin cututtukan koda. A Kasuwar Medonet, zaku iya siyan detox na ganye - shayi na ganye na muhalli tare da masara, pansy, yarrow da blackcurrant a cikin abun da ke ciki.