Ms. Hoa, 67, had hypertension for about 10 years and was undergoing treatment for stage 5 chronic kidney disease. For two months, she daily consumed only porridge, various seeds, and bone broth. She largely avoided rice, meat, fish, and eggs, fearing that protein-rich foods would accelerate her disease progression.

After two months, her weight dropped from 46 kg to 43 kg, leaving her severely weakened. An examination at Tam Anh General Hospital Hanoi revealed first-degree thinness (BMI 18,04), malnutrition alongside stage 5 chronic kidney disease, and anemia resulting from vitamin B12 deficiency and multiple micronutrient deficiencies.

According to Doctor Nguyen Thi Minh Anh from the Department of Nephrology and Dialysis, many patients with chronic kidney disease mistakenly believe that severely restricting protein-rich foods reduces the metabolic burden on their kidneys. Consequently, they consume only porridge, seeds, or bone broth for extended periods. In reality, managing chronic kidney disease does not mean eating as little as possible; it means eating correctly and sufficiently. Patients must control their protein intake according to their disease stage, not completely eliminate protein-rich foods. When a diet lacks both energy and protein, the body breaks down its own muscle mass to sustain function, leading to weight loss, muscle wasting, and malnutrition, which negatively impacts treatment effectiveness.

Doctors developed a personalized diet plan for Ms. Hoa, tailored to her kidney function. This plan ensured adequate energy and appropriate protein levels, while also adjusting her meals to improve her digestive disorders. She undergoes regular monitoring of her weight, muscle mass, and nutritional indicators to prevent progressive malnutrition, maintain her physical condition, and improve treatment efficacy.

The patient's weight is monitored after dietary adjustments. *Tam Anh General Hospital*

After one month of treatment, Ms. Hoa's appetite improved, her digestive disorders resolved, and her weight and physical condition improved. Her malnutrition is gradually controlled, and nutritional indicators are more stable, which facilitates the effective management of her chronic kidney disease. She continues to receive regular monitoring and dietary adjustments based on her disease progression.

Doctor Minh Anh advises patients with chronic kidney disease to undergo regular check-ups and nutritional assessments, especially if they experience weight loss, loss of appetite, fatigue, or reduced muscle strength. Diets must be personalized according to kidney function and combined with consistent monitoring of weight and nutritional indicators throughout treatment. Patients should not arbitrarily eliminate food groups; instead, eating correctly, sufficiently, and at appropriate times helps prevent malnutrition, improves treatment efficacy, and enhances quality of life.

Thu Giang

*Patient's name has been changed