This section is from the book "Food And Feeding In Health And Disease", by Chalmers Watson. Also available from Amazon: Food and Feeding in Health and Disease.
No special reference is necessary to the dietetic treatment of other renal disorders. These have all to be treated along the general lines indicated on p. 410. One special point should, however, be noted. In conditions associated with pyelitis, attention should be directed to the reaction of the urine. Benefit is sometimes obtained by prescribing a diet rich in vegetable substances, so as to reduce the acidity of the urine. A meat meal should not be given more than once daily (see also p. 526). In cases of tuberculous disease it may be advisable to ignore to a great extent the condition of the urine, and to concentrate attention on the general condition of the patient.
Albuminuria is merely a symptom, and as such hardly calls for consideration here. The first point to determine is whether the albuminuria is a result of demonstrable organic disease such as acute, subacute, or chronic nephritis, or whether it is of a so-called functional type such as occurs after exertion, or, in a few cases, during the height of digestion. The albuminuria of adolescence is closely related to the albuminuria of posture. When the albuminuria depends on organic kidney disease, the appropriate dietetic treatment should be carried out; in other cases, no special dietetic rules apply, with the exception of restricting the immoderate use of animal proteins, especially red meat and eggs.
The uric acid excreted in the urine is derived from two sources: from the food (exogenous purins), and from tissue metabolism (endogenous purins). The former only can be influenced by diet. While the acidity of urine is not due to uric acid but to acid sodium phosphate, the deposition of uric acid occurs in an acid urine, and it may be desirable to make the urine temporarily neutral or slightly alkaline in reaction. _In this connection it is important to note that milk and vegetable food favour alkalinity of the urine, while meat foods tend to make the urine acid. The free use of fresh green., vegetables should therefore be encouraged, as their alkaline salts are of value in tending to promote an alkaline state of the urine. Moreover, certain articles of diet are rich in purins, e.g., sweetbreads, thymus, tea, coffee, lentils, and meat and these must be .restricted or, it may be, withheld for a time. At the same time it must be borne in mind that an excessive meat diet is not by any means the sole cause of lithaemia; not infrequently the condition arises from the excessive use of farinaceous and saccharine foodstuffs. Abnormal decomposition of these foodstuffs in the intestine is followed by derangement of the liver function, with resultant changes in the blood and urine (lithaemia). Diluents have special value as general diuretics, and are further useful in correcting the catarrhal state of the pelvis of the kidney which is frequently present in these cases, and is a contributory factor in the etiology of the condition. (See also Auto-intoxication, p. 346; Purin-free diet, p. 531; and Gout, p. 444).
In oxaluria the greater part of the oxalic acid excreted in the urine in the form of oxalates is derived solely from the food or from the products of the decomposition of the food in the alimentary tract. The treatment of oxaluria consists, therefore, in withholding from the diet substances rich in oxalic acid, such as cocoa, black tea, spinach, tomatoes, rhubarb, pepper, sorrel, figs, strawberries, apples and pears, and in the administration of a diet little prone to fermentation and decomposition in the intestinal tract. Raw fruits and vegetables which contain citric, malic, and other organic acids have an important relation to the formation of oxalic acid. The diet appropriate to this condition, therefore, consists chiefly of various meat foods, milk, eggs without the yolk, and stale bread or rusks; this diet also acts beneficially by increasing the acidity of the urine due to increase of the acid phosphates, which help to keep the oxalates in solution. The free use of diluents, aided by small doses of sulphate of magnesia, is an important adjuvant to treatment. Dilute mineral acids, hydrochloric or nitro-hydrochloric, are of value if taken in 15 to 20 minim doses immediately after food (see also Auto-intoxication, P. 346).
The occurrence of phosphaturia is favoured by a diet rich in fruit and fresh green vegetables, and it is diminished by a diet from which these are excluded. Meat, eggs, milk, cheese, cereals, and legumes should therefore comprise the dietary in these cases.
 
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