A patient with diabetes has had many renal calculi over the past 20 years and now has chronic renal failure. Which substance must be reduced in this patient’s diet?
A. Carbohydrates
B. Fats
C. Protein
D. Vitamin C
Correct Answer: C. Protein
Because of damage to the nephrons, the kidney can’t excrete all the metabolic wastes of protein, so this patient’s protein intake must be restricted. Eating animal protein may increase the chances of developing kidney stones. Although you may need to limit how much animal protein you eat each day, you still need to make sure you get enough protein. Consider replacing some of the meat and animal protein you would typically eat with beans, dried peas, and lentils, which are plant-based foods that are high in protein and low in oxalate.
Option A: Eat oxalates wisely. Foods high in this chemical may increase formation of kidney stones. If you’ve already had kidney stones, you may wish to reduce or eliminate oxalates from your diet completely. If you’re trying to avoid kidney stones, check with your doctor to determine if limiting these foods is enough.
Option B: Good sources of calcium include milk, yogurt, cottage cheese, and other types of cheeses. Vegetarian sources of calcium include legumes, calcium-set tofu, dark green vegetables, nuts, seeds, and blackstrap molasses. If you don’t like the taste of cow’s milk, or, if it doesn’t agree with you, try lactose-free milk, fortified soy milk, or goat’s milk.
Option D: Citrus fruit, and their juice, can help reduce or block the formation of stones due to naturally occurring citrate. Good sources of citrus include lemons, oranges, and grapefruit. A higher intake of carbs, fats, and vitamin supplements is needed to ensure the growth and maintenance of the patient’s tissues.
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