The onset of diabetic nephropathy is accompanied by impaired renal function. The disease develops gradually. In this case, several stages of the disease are distinguished, each of which is characterized by a specific symptom and degree of organ damage.

For the treatment and prevention of the disease at every stage, apart from drug treatment, you must adhere to a proper diet. The diet for diabetic nephropathy depends on the stage of the disease. As a rule, one of the three types of low-protein diets is used - 7, 7 a, 7 b.

Each diet is used in the complex treatment of diabetic nephropathy.

Baking, and steaming are preferred in cooking.

This diet with nephropathy allows you to remove nitrogen metabolic products from the body, helps reduce blood pressure, and reduces edema. It is prescribed in the early stages of the disease, is also used in acute nephritis, and is prescribed from 3-4 weeks from the beginning of treatment. Also, a diet suitable for chronic jade.

This dietary food limits the number of fats and carbohydrates in the patient’s body. To prepare a diet food you almost have to completely give up the use of salt.

With your doctor’s permission, you can add a little salt to your dish before use. The daily amount of liquid is also limited - taking into account liquid dishes, it should not exceed 1 l.

Important: diet no. 7 prohibits the use of essential oils, ie horseradish, onion, and garlic, as well as oxalic acid, fatty meat, fish, mushrooms, and extractives.

In culinary food processing, baking, cooking, and steaming are preferred. Fried food is contraindicated. It is not necessary to use mechanically economical food, that is, it does not need to be ground and ground. Meat and fish with low-fat content can be cooked and eaten 100-130 g per day. All food should be warm.

Total caloric diet - 2700-2900 kcal:
Carbohydrates - 40-460 g (of which sugar is only 80-90 g).
Protein - 80 g (only half can be of animal origin).
Fat - 90-110 g (a quarter of them should be vegetables).
Salts - no more than 10 g per day.
Liquids (meaning not only water but also soup, and tea) - no more than 1.1 liters.
Eat 4-5 times with equal intervals between meals.
List of allowed products:
bread without salt, pancakes, pancakes with yeast without salt;
fruit and vegetarian soups on vegetables and cereals;
low-fat veal, boiled tongue, beef, chicken, rabbit, lamb, and low-fat pork porridge;
cooked fish with low-fat content (you can bake fish, stuffing, fill);
sour-milk drinks, sour cream, milk, cottage cheese with rice, carrots, and apples;
no more than two eggs a week (you can daily, but then you need to reduce the amount of fish, meat, and cottage cheese), egg yolks can be added to dishes;
rice, corn and pearl barley, sago;
pasta;
any vegetables (cooked or steamed, baked);
vinaigrette without pickles;
fruit and vegetable salads;
raw fruits and berries;
jam, honey, jelly, and jelly in the diet, but diabetics can be used only as special sweets for diabetics.

The following products must be discarded completely.

plain bread and salty flour products;
legumes;
meat, fish, or mushroom soups;
smoked meat, canned meat, sausages;
fatty varieties of fish and meat;
fried foods;
smoked and salted fish, canned fish, caviar;
pickles, pickles, pickles;
radish, onion, garlic, as well as horseradish, spinach, radish, sorrel;
chocolate;
mushrooms.

In addition to renal failure and nephropathy, this mainly plant-based diet is used with a sharp reduction in the amount of salt and protein.

This therapeutic diet is prescribed when the first clinical signs of diabetic nephropathy appear, as well as in acute glomerulonephritis with severe PN. Such a diet for renal nephropathy is aimed at improving the excretion of metabolic products, reducing edema, reducing the manifestations of arterial hypertension, and saving the effect on the kidneys.

In addition to renal failure and nephropathy, this mainly plant-based diet is used with a sharp reduction in the amount of salt and protein. Moderately reduced carbohydrates and fats.

Foods rich in essential oils, and oxalic acid, are necessarily excluded from the diet. At the same time, culinary processing is just baking, cooking, and steaming. The products do not need to be crushed much. All food is cooked without salt.

You can only eat bread without salt. Six meals a day.

The total caloric content of this diet is 2150-2200 kcal:

Proteins - 20 g (half of them are proteins of animal origin and with CRF - 70%).
Fat - 80 grams (only 15% of them are vegetable fat).
Carbohydrates - 350 g (of which sugar is not more than 80 g).
It is important to completely eliminate salt.
Fluid volume is determined by the daily amount of urine. It must not exceed 0.5 l.

List of allowed foods:

protein-free and salt-free bread (based on corn starch) not more than 100 grams or bread without wheat salt, not more than 50 g / d, other yeast products from flour without salt;
vegetarian soups (can be seasoned with sour cream, herbs, and cooked fried onions);
low-fat rabbit meat, chicken, veal, beef, turkey - no more than 50-60 grams per day;
low-fat fish - no more than 50 g / d (you can cook, bake, or steam);
cream, sour cream, and milk - no more than 60 grams (more if you reduce the amount of daily protein due to fish and meat);
curd is possible if meat and fish are completely excluded;
¼ or ½ eggs daily as a dietary supplement or 2 eggs per week;
cereals - sago is allowed, the rice should be limited. They are cooked in water or milk like porridge, pilaf, spoon, pudding, or meatballs;
protein-free pasta;
fresh vegetables - about 400-500 g per day;
potatoes not more than 200-250 g / d;
You can eat parsley and dill, as well as fried boiled onions (add to dishes);
fruits, berries, compotes, various jellies, and fruit jellies;
honey, jam (for diabetics only special diabetic sweets);
you can use sweet and sour sauces to improve the taste (sour cream and tomatoes);
allowed cinnamon, citric acid, vanillin, fruit, and vegetable bunch;
it is permissible to drink weak tea with a slice of lemon, diluted juices, and vessels of a wild rose;
from fats, you can eat butter (unsalted) and vegetable oil.
Among the forbidden foods are the following:
all flour and bakery products with salt;
legumes;
dairy and cereals (except carpets);
meat, fish, and mushroom soups;
fatty varieties of fish and meat;
smoked meats, canned foods, pickles, and marinades;
hard cheese;
pasta (except protein-free);
all cereals except carpet and rice;
sour, salty, and sour vegetables;
sorrel, spinach, mushrooms, radish, cauliflower, garlic;
milk jelly, chocolate, ice cream;
meat, fish, and mushroom sauces;
horseradish, pepper, as well as mustard;
natural coffee, mineral water with plenty of sodium, cocoa;
animal fats.

This diet can be used in third-degree diabetic nephropathy, with acute glomerular nephritis, as well as severe renal failure. It is sometimes prescribed for chronic nephritis after a diet of 7 with moderate PN.

The purpose of this diet is the same as the first two - the excretion of metabolic products from the body, reducing edema, and arterial hypertension. This diet drastically limits salt and protein.

At the same time, the amount of carbohydrates and fats remains within normal limits.

The energy value of food cannot be decreased beyond a normal level, so when proteins are limited, diabetics are permitted to compensate with fats and sweets.

The diet contains approximately 2500-2600 calories.

Protein - 40-50 g (a large half of them of animal origin).
Fat - 83-95 g (a quarter of them of vegetable origin).
Carbohydrates - 400-460 g of which about 100 g of sugar.
Salt is completely excluded.
Fluid not more than 1.2 l with constant monitoring of urine excretion.

Diet depending on the stage of the disease

In the initial stage, you can adhere to a normal diet, but with small restrictions for preventive purposes. You can stick to diet number 7.
In the proteinuria phase, you should switch to a moderately low-protein diet (diet 7a). The daily protein intake is 0.75-08 g per kilogram of patient weight. That is, for men, it is approximately 55 g, and for women - 40-45 g. Half of the daily protein should be of animal origin.
In the third stage, you must adhere to the following principles of clinical nutrition:
Daily protein limitations depend on the severity of the CRF. This will reduce azotemia and increase the filtration of protein metabolites through the kidneys.
The energy value of the diet must be aligned with the energy expenditure in the body and increase its deficiency due to fats and carbohydrates. This will improve the absorption of protein from food and reduce the breakdown of protein from the body's reserves.
It is important to regulate the amount of fluid and salt, taking into account the excretory activity of the kidneys. With the appearance of edema and hypertension, it is necessary to drastically reduce the amount of salt and fluid.

Diabetes and everything about it

Among all the complications that threaten a person with diabetes, diabetic nephropathy is the leading one.

The first changes in the kidneys appear in the first years after diabetes, and the last stage is chronic kidney failure (CRF).

However, careful adherence to preventive measures, timely diagnosis, and adequate treatment help delay this disease's development as much as possible.

Diabetic nephropathy

Diabetic nephropathy is not an independent disease. This term combines several problems, the essence of which comes down to one thing - it is damage to the renal vessels in the background of chronic diabetes.

In the group of diabetic nephropathy, the following are most often detected:

renal arteriosclerosis;
diabetic glomerulosclerosis;
fatty deposits in the renal tubules;
pyelonephritis;
necrosis of renal tubules, etc.

Diabetic nephropathy is often referred to as Kimmelstil-Wilson syndrome (a form of glomerulosclerosis). In addition, the terms diabetic glomerulosclerosis and nephropathy are often used as synonyms in medical practice.

ICD-10 (the official international classification of diseases of the 10th revision), which has been universally valid since 1909, uses 2 codes for this syndrome. And in various medical sources, patient records, and reference books, you can find both options. These are E.10-14.2 (Diabetes mellitus with kidney damage) and N08.3 (Glomerular lesions in diabetes).

Most often, various renal dysfunctions have been reported in type 1 diabetes, ie insulin. Nephropathy occurs in 40-50% of patients with diabetes and is recognized as the leading cause of death from complications in this group. In persons suffering from type 2 pathology (independent insulin), nephropathy has been reported in only 15-30% of cases.