Alimentación Renal: ¿Por dónde empiezo?

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Alimentación Renal: ¿Por dónde empiezo?

Alimentación Renal: ¿Por dónde empiezo?

Por: Lcda. María Eugenia Rodríguez León

Board Certified as Specialist in Renal Nutrition

 Cada condición médica requiere recomendaciones nutricionales únicas. Además, la alimentación renal recomendada se basará en la etapa de la enfermedad (estadios 1 al 5) y en los resultados de laboratorios (albúmina, potasio y fósforo). Lo ideal es comenzar la alimentación renal en pacientes con insuficiencia renal en estadios tempranos (GFR mayor de 30 ml/min/1.73 m2) para ayudar a retrasar el progreso de la enfermedad. Es decir, preservar por el mayor tiempo posible la función actual de los riñones. El problema es que la mayoría de las personas con insuficiencia renal desconocen que tienen la enfermedad porque los síntomas y las complicaciones se comienzan a reflejar en etapas más avanzadas. Mientras más avanzada la enfermedad renal, mayores son las restricciones en la alimentación.

En general, todos los pacientes con insuficiencia renal deben:

  1. Seguir una alimentación baja en sodio: 1,500 mg al día. Para que tenga una idea de la restricción recomendada, una cucharadita de sal tiene 2,300 mg de sodio. ¡Mucho más de la recomendación diaria!

 Para alcanzar esta meta:

  1. Evita el uso de sal, adobo, cubitos y sazón. Prefiera hierbas, especies, sofrito y otros condimentos bajos en sodio para darle gusto a las comidas.
  2. Lea la etiqueta nutricional: escoja alimentos con 140 mg de sodio o menos. Evite alimentos procesados, enlatados y ahumados. De igual forma, evite las salsa y los aderezos.
  3. Añada más frutas frescas o enlatadas y vegetales frescos o congelados. Son naturalmente bajos en sodio.
  4. Prefiera comer en el hogar. La mayoría de las comidas fuera del hogar son altas en sodio. Si tiene que comer fuera del hogar, prefiera un lugar donde le puedan preparar en el momento un plato bajo en sodio. No tenga miedo de preguntar los ingredientes de un plato del menú y pedir cambios de ingredientes para que se ajuste a sus necesidades. En ocasiones, le pueden ofrecer alternativas fuera del menú.
  5. Evite los embutidos como “hot dog”, “corned beef”, jamonilla y cortes fríos como jamón, salami entre otros. Prefiera sándwich preparados con pechuga de pollo o pavo fresco.
  1. Seguir una alimentación baja en proteínas. Sobre este tema existe mucho debate. Sin embargo, el tipo y la cantidad de proteína que se consuma puede disminuir el deterioro de los riñones y disminuir la proteinuria (cantidad de albúmina que se pierde en la orina). No se recomienda eliminar por completo las proteínas ya que son necesarias para mantenernos bien nutridos (albúmina adecuada).

El Instituto de Medicina de los Estados Unidos ofrece la siguiente guía para la población saludable:

Ingesta de proteínas

diaria (g)

Mujer 46
Hombre 56

 

El puertorriqueño, en general, consume exceso de proteínas. Es fácil observar las porciones de proteínas que nos sirven cuando comemos fuera del hogar.

El requisito de proteína diario también se puede calcular según su peso ideal tomando en consideración condiciones médicas y estadio de la insuficiencia renal. Este cálculo es el que un nutricionista dietista licenciado utiliza para preparar el plan de alimentación renal. De este requisito diario, el 50% de las proteínas deben ser de alto valor biológico.

Fuentes de Proteína de Alto Valor Biológico
Reino Animal Reino Vegetal
Aves

Pescados

Mariscos

Huevos

Leche, queso, yogurt

Habichuelas

Semillas

Nueces

Soya y sus derivados

 

CANTIDAD DE PROTEINA EN ALIMENTOS
Fuentes de Proteína Proteínas (g)
Aves
½ Pechuga de Pollo 29
3 oz Pavo 24
Mariscos
6 Camarones, grandes 10
Pescado
3 oz. Atún enlatado 20
3 oz. Salmón 19
Huevo  
¼ taza Sustituto de huevo 6
1 Huevo, grande 6
2 Claras de huevo, grande 7
Lácteos
1 oz Queso 7
4 oz Leche 4
4 oz Yogur sin grasa 6
Habichuelas y Nueces
½ taza Garbanzos 7
½ taza Habichuelas 8
½ tazas Lentejas 9
1 oz Nueces mixtas 5
1 oz Almendras 6
2 Cdas Mantequilla de maní 8
¼ taza Humus 5

 

 

 

 

 

 

 

 

 

 

 

Siempre se recomienda evitar las carnes rojas y el cerdo. Además de, sustituir en varias comidas durante la semana la proteína animal por proteína vegetal. Estudios científicos han demostrado que llevar una alimentación vegetariana es de beneficio para los riñones.

En etapas más avanzadas (GFR menor de 30 ml/min/1.73 m2), puede necesitar ajustes adicionales en su plan de alimentación según los resultados de laboratorio y el progreso de la condición. En adición, puede ser necesario el restringir el potasio, fósforo y líquidos. Un nutricionista dietista licenciado puede preparar su plan de alimentación en la visita inicial y ajustarlo según sea necesario en las visitas de seguimiento.

 

 

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