Renal Osteopathy: Therapy

General measures

  • Any concomitant medical conditions should be carefully monitored and treated.
  • Blood pressure should be optimally adjusted.
  • Blood lipids (blood fats) should be controlled and, if necessary, brought to a low level.
  • Nicotine restriction (refrain from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Preservation of normal weight strive!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.

Conventional non-surgical therapy methods

  • Drug phosphate fixation is often required. In patients with terminal renal insufficiency: partly by dialysis (approx. 250 mg/day).

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Observance of the following specific nutritional recommendations:
    • Daily energy intake: about 35 kcal per kg body weight.
    • In general, the diet should be low in protein (low protein), but due to the risk of malnutrition, protein intake should not be reduced too drastically. In addition, the daily protein intake (per kg body weight) depends on the stage of renal impairment (as recommended by the doctor)!
    • Avoidance or reduction of monosaccharides (simple sugars) and disaccharides (double sugars) and high intake of complex carbohydrates.
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • Low cholesterol diet
    • Diet rich in fruits and vegetables
    • A diet low in sodium chloride (< 6 g/day) should also be followed.
    • In advanced renal insufficiency (kidney weakness), no more than 1 g of phosphate per day (dietary phosphate reduction* with the target: 800-1,000 mg/24 h) should be ingested to mitigate the consequences of disturbances on vitamin D and bone metabolism.Foods rich in phosphate are mainly dairy products, eggs, meat, fish, cheese, nuts, dried vegetables and wheat bran. Detailed information on the content of phosphate in foods (See food list – Phopshat).
    • In the stage of (pre)terminal renal failure, potassium levels may be elevated. Then potassium-rich foods such as dried fruits, dried vegetables, dishes from dried potatoes should be urgently avoided and wheat bran, stockfish, spinach, tomato paste, ketchup, pistachios, roasted peanuts, chocolate, wine, fruit and fruit juices should be consumed in a restricted manner.
    • Daily drinking amount: 3 liters to be able to eliminate urinary substances and avoid dehydration (lack of fluid) (Warning: does not apply in cases of edema (water retention), manifest nephrotic syndrome and heart failure (cardiac insufficiency)). In addition, if advanced renal insufficiency (kidney weakness) is present, the following recommendations apply:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

* CKD = chronic kidney disease

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