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WS/T 557-2017: Dietary guide for chronic kidney disease patients
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Dietary guide for chronic kidney disease patients
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WS/T 557-2017
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Basic data | Standard ID | WS/T 557-2017 (WS/T557-2017) | | Description (Translated English) | Dietary guide for chronic kidney disease patients | | Sector / Industry | Health Industry Standard (Recommended) | | Classification of Chinese Standard | C55 | | Word Count Estimation | 16,185 | | Date of Issue | 2017-08-01 | | Date of Implementation | 2018-02-01 | | Regulation (derived from) | State-Health-Communication (2017) 10 | | Issuing agency(ies) | National Health and Family Planning Commission of the People's Republic of China | WS/T 557-2017: Dietary guide for chronic kidney disease patients---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Dietary guide for chronic kidney disease patients
ICS 11.020
C 55
WS
People's Republic of China Health Industry Standard
Dietary guidance for patients with chronic kidney disease
Issued by the National Health and Family Planning Commission of the People's Republic of China
Foreword
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
The main drafting organizations of this standard. Peking Union Medical College Hospital, Peking University First Hospital, Chinese People's Liberation Army General Hospital, Shanghai Huashan Hospital,
Shanghai First People's Hospital, Shanghai Sixth People's Hospital, Chinese Center for Disease Control and Prevention Nutrition and Health Institute, West China Hospital of Sichuan University, South China
General Hospital of Beijing Military Region, First Affiliated Hospital of China Medical University, Guangzhou Red Cross Hospital, Qilu Hospital of Shandong University.
The main drafters of this standard. Chen Wei, Li Xuemei, Liu Yanping, Li Hailong, Dong Jie, Xue Changyong, Liu Jingfang, Chen Jing, Yuan Weijie, Ge
Sheng, Zhang Jian, Yang Xiaoguang, Fu Ping, Hu Wen, Zheng Jinfeng, Shi Wanying, Tan Rongshao, Hu Zhao.
Dietary guidance for patients with chronic kidney disease
1 Scope
This standard specifies the dietary guidelines for patients with chronic kidney disease, the recommended intake of energy and nutrients, the formulation of dietary prescriptions, and nutrition
Intake monitoring and evaluation.
This standard applies to dietary guidance for patients with chronic kidney disease.
2 Terms and definitions
The following terms and definitions apply to this document.
2.1
Chronic kidney disease; CKD
Renal injury or GFR confirmed by renal biopsy or detection of renal injury markers lasts less than 60 mL/(min·1.73m²) ≥ 3 months. Kidney damage
Positive indicators of injury include abnormal blood and urine components or abnormal imaging studies.
2.2
Stage of CKD
CKD is staged according to GFR value, see Table 1.
2.3
Medical nutrition therapy; MNT
Nutritional treatment measures for specific diseases under clinical conditions, including individualized nutritional assessment, diagnosis, and nutrition of patients
The formulation, implementation and monitoring of treatment plans.
2.5
High quality protein
Complete protein
The essential amino acids contained in protein are complete, sufficient, and proportioned, such as protein from animal sources (such as milk, egg
Class, meat, etc.) and soy protein.
2.6
Food exchanges based on protein
Common foods are divided into different categories according to their sources and properties. Similar foods contain similar protein and energy within a certain weight.
Similar foods can be interchanged, which enriches the range of food choices.
3 Dietary guidelines for patients with chronic kidney disease
3.1 Balanced diet
While properly limiting protein intake, ensure adequate energy intake to prevent malnutrition. Diversified choices and reasonable nutrition
food.
3.2 Reasonably plan meals and energy and protein distribution
Eat regularly and quantitatively, the energy of breakfast, lunch and dinner can account for 20%-30%, 30%-35%, 30%-35% of total energy. Evenly distribute three
Protein in meals. To ensure sufficient energy intake, snacks can be added between meals, accounting for 5% to 10% of the total energy.
3.3 Individualized meal plan and nutrition education
Individualized dietary arrangements and corresponding nutritional education should be carried out according to the patient’s lifestyle, CKD staging, nutritional status, and economic conditions.
3.4 Food choices
3.4.1 Restrict the intake of plant protein such as rice and noodles, and use wheat starch (or other starch) as the staple
Rice, noodles, milk, eggs, various meats, soy protein and other high-quality protein foods are the main sources of protein.
source.
3.4.2 Foods that can be used include potatoes, sweet potatoes, lotus roots, water chestnuts, noodles, yam, taro, pumpkin, vermicelli, water chestnut powder and other rich foods.
Starch-containing foods replace ordinary staple foods. Low-phosphorus, low-potassium, low-protein rice and noodles can also be used to replace ordinary staple foods.
3.4.3 When the disease needs to restrict foods with high phosphorus content, animal liver, nuts, dried beans, and various processed foods containing phosphorus should be carefully selected
Wait.
3.4.4 When the disease needs to limit foods with high potassium, fruits, potatoes and their starches, green leafy vegetables, etc. should be carefully selected.
When the patient's energy intake is insufficient, some carbohydrates and vegetable oils can be added to the food to achieve the required energy.
4 Recommended intake of energy and nutrients for patients with chronic kidney disease
4.1 Energy
4.2 Protein
4.3 Fat
The daily fat energy supply ratio of CKD patients is 25% to 35%, of which saturated fatty acids do not exceed 10%, and trans fatty acids do not exceed 1%. Can be appropriately mentioned
High intake of n-3 fatty acids and monounsaturated fatty acids.
4.4 Carbohydrates
Appropriately increase the intake of carbohydrates on the basis of reasonable total energy intake, and the carbohydrate energy supply ratio should be 55%-65%. Have
People with abnormal glucose metabolism should limit the intake of refined sugar.
4.5 Minerals
In each stage of CKD patients, the sodium intake should be less than.2000 mg/d, the phosphorus intake should be less than 800 mg/d, and the calcium intake should not exceed.2000 mg/d.
When CKD patients develop hyperkalemia, potassium intake should be restricted. When anemia occurs, foods with high iron content should be supplemented. Other trace elements
It is advisable to maintain the normal range in the blood to avoid abnormal blood electrolytes.
4.6 Vitamins
Long-term treatment of CKD patients need to be supplemented with natural vitamin D in order to improve mineral and bone metabolism disorders. You can choose to push if necessary
A multi-vitamin preparation within the intake range is recommended to supplement the daily dietary deficiency and prevent vitamin deficiency.
4.7 Dietary fiber
According to the daily energy intake, the recommended dietary fiber intake is 14 g/4180 kJ (1000 kcal).
4.8 Liquid
When CKD patients have oliguria (less than 400 mL of urine per day) or have severe cardiovascular disease or edema, water intake should be appropriately restricted
In order to maintain a balance of input and output.
5 Formulation of dietary prescriptions for patients with chronic kidney disease
Using the five-step method, calculate the total daily energy and protein requirements of the patient based on the patient’s height, weight, activity intensity, CKD staging, etc.
And calculate the number of exchanges based on food protein, and finally distribute them to the meals throughout the day. See Appendix A for examples.
6 Monitoring and evaluation of nutritional intake in patients with chronic kidney disease
6.1 Nutrition status monitoring
Patients with CKD stages 3 to 5 are prone to malnutrition due to diseases and nutrient intake restrictions, and the nutritional status of patients should be monitored regularly.
When controlling protein intake, patients' compliance and nutritional status should be closely monitored to prevent malnutrition. If there is a camp
The occurrence of malnutrition should be monitored once a month.
6.2 Monitoring of dietary compliance
The patient's 24-hour urine urea excretion should be tested regularly to assess the patient's actual protein intake and maintain nitrogen balance. Adopt three days
The diet review method regularly evaluates the dietary intake of energy and nutrients.
6.3 Nutritional assessment
Regularly adopt a variety of methods to monitor the nutritional status of patients and comprehensively analyze them, including body measurements, such as weight, body mass index, and triceps
Skinfold thickness, upper arm muscle circumference, grip strength, calf circumference, etc.; body composition analysis; commonly used biochemical indicators, including serum total protein, white
Protein, prealbumin and total cholesterol, etc.; comprehensive evaluation method, such as subjective comprehensive evaluation method, etc. for comprehensive evaluation.
AA
Appendix A
(Informative appendix)
Example of daily diet design for patients with chronic kidney disease
Example. Mr. Zhang, 67 years old, male, chronic kidney disease CKD stage 4, height 172 cm, current weight 60 kg, no lower extremity edema, taken
With diet treatment, no obvious complications occurred.
BB
Appendix B
(Informative appendix)
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