Derangements of the Kidneys
In the dietetic treatment of any diseased organ, the object must be to give that organ as much rest as consistent with keeping up the general nutrition of the system. The stomach and intestines are so closely allied that, where one is affected, the other is liable to affection also, and the dietetic treatment is regulated accordingly. Yet generally speaking, in stomach disorders the quantity of protein is limited; in intestinal disorders the starches, sugar and fats are limited. Since the office of the kidneys is to pass from the system the soluble salts and the nitrogenous waste, which dissolve in water, the work of the kidneys in most conditions is aided by a copious drinking of water. Since uric acid is stimulated by the kidneys, the proteins should be restricted in the diet, particularly those formed from the glands of animals,—as liver, sweetbreads, kidneys, also brains. Potatoes, green vegetables, stone fruits and cranberries aggravate an acute condition.
Acute Nephritis. In case of inflammation of the kidneys the excretions are interrupted. In this event the quantity of water should be limited to three to four glasses a day. In the event that the kidneys will not excrete the water, the pores of the skin must be kept freely open by sweat baths to assist in the elimination of waste.
Dr. Hall recommends a milk and cream diet of from three to seven pints a day, for a few days, according to the case,—two parts of milk to one of cream. If the urine is scanty, he reduces it to one and one half pints a day, taken in four or five installments. After the three to seven days of milk diet he gradually introduces starches and fats.
Brights Disease. This term covers forms of diseases of the kidneys, associated with albumin in the urine.
Where for any reason the kidneys have difficulty in discharging the nitrogenous waste of the system, the work of the dietitian must be to eliminate protein from the diet as closely as may be consistent with the body necessities. Besides restricting the amount of nitrogenous foods, the kidneys must be assisted in eliminating the nitrogenous waste, and the products of the inflammation, by a copious drinking of water. Hot water and hot diluent drinks are best, such as toast water, barley water, cream of tartar, lemon and acid drinks. In acute cases the patient is put on a milk diet of from two to three pints of milk a day, given one-half pint every three or four hours, diluted with one-third as much hot water. If the case be a prolonged one, broths may be included.
Even in cases which are chronic and not acute, it is well to follow a milk diet for a number of weeks. The quantity of milk, for an exclusive milk diet, must depend upon the age and size of the patient as well as upon his ability to exercise. If he is confined to his room, from five to seven pints of milk a day are sufficient. If he is taking a great deal of exercise, he may take from eighteen to twenty glasses of milk a day. If he loses weight on the milk diet, bread and rice may be added.
It is unwise to begin a milk diet at once, by feeding from eighteen to twenty glasses of milk a day, but this amount may be approximated within a week’s time and the change in diet should be begun by cutting down all meats and legumes and gradually eliminating starches. In changing from a milk diet to a diet including more hearty foods, the transition should be gradual.