FAQs for CRF and renal replacement therapy

Is it necessary to restrict diet in CRF children?

YES

1. Protein

   Enough protein is needed for growth of the child, but excess protein will lead to production of excess solutes after metabolism, which may exceed the excretory capacity of the failing kidneys with subsequent retention and ill effects on the child.

2. Sodium salt

   Excess salt will lead to fluid retention and high blood pressure. In congenital causes of CRF, sodium loss may occur; and in this situation, sodium restriction is not necessary

3. Fat

   High lipid level may occur in children with CRF, and fat intake may aggravate the situation.

4. Potassium

   Diet high in potassium should be avoided as high blood potassium may be lethal

5. Phosphate

   Failing kidneys have limited capacity to excrete phosphate, low phosphate diet is preferred to avoid phosphate retention which has negative effect on the bones

6. Water

   In general, appropriate fluid intake is needed as inadequate intake may lead to dehydration which is not good to the kidneys and excess intake may results in puffiness of face, hypertension or even pulmonary edema

* Dietetic advice is necessary on the amount and the selection of the right type of food.

Any food avoidance?

1. no star food – may lead to worsening of renal function in CRF patients
2. no caterpillar fungus – may cause disturbance of cyclosporin metabolism in kidney transplant patients
3. avoid nephrotoxic drugs
4. avoid unknown TCM

What are the choices of activity?

1. contact sports should be avoided in children with catheter in situ to avoid accidental pulling of the catheter
2. swimming should be restricted in chronic PD children and chronic HD children with permcath; and if having swum, immediate cleansing of the exit site should be carried out to avoid bacteria infection

Can every body donate kidneys?

Adults with normal mentality can be an initial candidate. In general, to protect the donor, fitness to donate is granted only after a normal medical examination coupled with normal laboratory tests and imaging studies of the urological system. Also the donor should not have infective diseases such as HIV infection, hepatitis B or C.

In the state of CRF, can we slow the progression or rate of deterioration of renal failure?

YES. Basically, good blood pressure control, reduction of proteinuria if present and lowering of serum lipid level are beneficial. Urinary tract infection should be promptly diagnosed and treated. Obstruction should be relieved. Kidney toxic drugs should be avoided as far as possible. Aggressive treatment of the originally disease such as glomerulonephritis should be attempted if there is any chance of reversal of kidney functions.