Post Date December, 03 2023
Patients with chronic kidney disease (CKD) can develop anemia at any stage as their renal function decreases, and anemia is more common at CKD5. In addition, nephrotic patients with diabetes are more likely to have anemia.
Iron deficiency anemia is very common in patients with renal anemia. Especially in hemodialysis patients, iron deficiency is caused by blood loss due to impaired intestinal absorption of iron, intestinal bleeding, blood withdrawal, and residual dialyzer blood. In clinical practice, erythropoietin (EPO) therapy is commonly used to achieve or maintain normal hemoglobin (Hb) levels, and the use of EPO can increase the demand for iron while increasing Hb. Therefore, dietary iron supplementation is crucial for patients with renal anemia.
Dietetic guidance
Eating foods rich in iron, giving priority to animal foods
The nature is rich in iron containing foods, including kelp, seaweed, agaric, mushrooms, beans and their products, animal blood, red meat, egg yolk, animal liver and kidney, and nuts; Dairy products and fruits are low in content.
Iron in food is divided into heme iron and non heme iron. Heme iron mainly exists in animal foods and is easily absorbed by the body, with an iron absorption rate of up to 20%; Non heme is mainly found in plant foods and is interfered by phytic acid, oxalic acid, tannic acid, etc. during absorption, with a generally low absorption rate of only 1% - 5%. Therefore, priority should be given to animal based foods for dietary iron supplementation.
Simultaneous intake of nutrients that promote iron absorption
Many nutrients can promote iron absorption, such as:
protein
Protein can stimulate gastric acid secretion and promote iron absorption. For non dialysis patients with renal anemia, it is still necessary to adopt a low protein diet and ensure the intake of high-quality protein. Therefore, patients with renal anemia should choose animal based foods as much as possible to supplement iron and high-quality protein, such as beef, lean pork, and blood products such as pig blood; The liver is a "concentrated nutrition bank" rich in vitamins and minerals. For dialysis patients, if there are no biochemical abnormalities, they can eat it 1-2 times a week.
Some vitamins
Vitamin C, vitamin A, folic acid, vitamin B6, and vitamin B12 play an important role in assisting in the absorption of iron. Therefore, when the blood potassium and phosphorus in patients with renal anemia are normal, they can eat more fresh vegetables and fruits to promote the absorption of iron.
Acidic substances
Due to the fact that the body can only absorb divalent iron, many acidic substances can maintain the form of divalent iron and promote iron absorption, such as lactic acid, malic acid, and acetic acid.
Avoid ingesting ingredients that inhibit iron absorption
mineral
Excessive intake of many minerals can inhibit iron absorption, such as calcium, lead, and chromium. Therefore, for patients with renal anemia, try to avoid taking calcium supplements or drugs while taking iron supplements.
Oxalic acid, tannic acid, etc
Oxalic acid, tannic acid, phytic acid, etc. contained in plant foods can combine with iron to hinder iron absorption. Therefore, it is best to blanch fruits and vegetables with astringent taste before eating them.
