신장 건강: 식단, 운동 및 의학적 고려 사항

박건 박사는 신장 건강 관리를 위해서는 규칙적인 운동과 신독성 약물을 피하는 것이 중요하다고 말합니다.

### 신장 건강에 대한 일반적인 오해를 바로잡고 명확히 하기
* 👩 ⚕️ 신장 질환의 종류에 따라 특정 치료를 통해 **신장 기능을 회복**할 수 있으므로 정확한 진단이 중요합니다.
* 🍽 신장 건강에는 식단이 중요하지만, **현대인의 낮은 신체 활동량**은 간과되는 경우가 많습니다.
* 저염식이 구식이라는 오해와는 달리, **1990년대와 2000년대 역학적 증거를 바탕으로 신장 건강에 유익**하다는 것이 입증되었습니다.
* 🍌 바나나와 같이 칼륨이 풍부한 식품에만 의존하기보다는 **균형 잡힌 식단에서 칼륨 섭취**를 강조하는 것이 더 객관적입니다.
* 만성 신부전 환자는 **칼륨 섭취가 고칼륨혈증을 유발**할 수 있으므로 칼륨 섭취에 주의해야 합니다.
* 🏋 규칙적인 운동은 신장 건강 유지의 핵심 요소이며, 특히 **당뇨병 환자에게는 혈당 수치 관리**가 매우 중요합니다.
* 🥗 나트륨 섭취를 줄이고 미네랄, 미량 원소, 단백질 섭취를 늘리는 데 중점을 둔 **DASH 식단**은 신장 건강을 위해 권장됩니다.

Hello, this is Dr. Jung Jong-cheol from Bundang Seoul National University Hospital, Department of Nephrology. There is a lot of information on the internet, but today, I will take some time to verify whether such information is accurate or not. [Music] Hello, I'm your health doctor, Dr. Geon Park, who reveals information that doctors never tell you on Dr. Geon Park TV. As a nephrologist, one thing I want to correct is that there is no way to reverse it once it's damaged. Depending on the type of disease, the treatment methods vary significantly. Even if you feel a bit desperate when your kidney function is almost completely lost, depending on the type of disease, there are many kidney diseases where you can recover kidney function through specific treatments. So, it seems like you may have misspoken a bit. Therefore, it is important to have an accurate diagnosis.

First of all, I would like to talk about something fundamental. Before it seriously deteriorates, the most important thing is to consume good food for lifelong kidney health management. It's actually not easy to say that it is the most important because kidney diseases deteriorate due to complex causes. However, what is important is that although diet is important, one of the most overlooked things among us modern people is the low level of physical activity. Neglecting that aspect and overly emphasizing only the diet could be a bit biased. Appropriate medication is also very important, and avoiding medications that harm the kidneys is crucial. Focusing only on food is somewhat different from reality. I would like to mention that. However, many people have a misunderstanding. The fact is that low-salt diet is a way to protect the kidneys.

It has been proven that even with a high intake of sodium, it does not affect the mortality rate due to kidney disease. The fact that a low-salt diet is beneficial for kidney disease is not a long-known fact as it is relatively recent, based on epidemiological evidence from the 1990s and 2000s. It's not like facts from the 50s or 60s, but rather through scientific methods, the effectiveness of a low-salt diet has been known. I would like to point out that it is not an outdated or obsolete belief. What's even more important is potassium. Even if you consume a lot of sodium, as long as you also consume a lot of potassium, there is no problem at all. It was an interesting point made that even with a high sodium intake, if you consume a lot of potassium, the positive effects of potassium will outweigh the negative effects.

Although there have been reports on the epidemiological association of why potassium supplementation is beneficial in terms of reducing long-term mortality, the mechanism behind it is still just a hypothesis. Therefore, it is a bit difficult to conclusively state. Let's delve a bit deeper. Of course, for patients with serious kidney disease, it is not well known how to fundamentally keep the body healthy through food. You were explaining it well, but you slightly shifted towards blaming the medical staff. Even if you consume a lot of sodium, it is okay as long as you also eat potassium. Why do you keep insisting on just focusing on food when calling? There are several reasons for this. One reason is that patients with chronic kidney failure, whose kidneys are damaged, may exceed the normal potassium concentration when taking potassium, leading to hyperkalemia, which can be fatal as it can cause arrhythmia.

Because it is related to sudden cardiac death, it is very cautious to recommend inducing hyperkalemia. However, as epidemiological evidence is accumulating, unless the renal function is extremely compromised, we are not yet recommending the intake of potassium-rich vegetables or nuts, but rather limiting it to some extent. The focus in clinical practice is much more conservative, and encountering patients with hypokalemia in practice is very rare. This is because the body's potassium balance is regulated by the kidneys, so even with low potassium intake, a decrease in potassium concentration in the body is rare. Potassium is low in patients with impaired renal function regulating potassium balance. Towards the end, doctors criticized why there is little interest in food.

Interestingly, the individuals who led the research on diets are doctors. They are very interested and conducting a lot of research on low-sodium and high-potassium diets. These studies have been steadily protected from the 2010s to the 2020s. Since it is a study conducted by a single institution, the process of inducing an overall consensus in the medical field is currently ongoing. Therefore, until there is more consensus in the medical field, it is recommended to maintain a low-sodium diet. And it is not to negate the results of the research. Epidemiological studies have been conducted on a large scale, which is very meaningful, but caution is needed in interpreting them. Especially for patients with diseases visiting hospitals, different mechanisms may operate compared to the general population. Therefore, it may be difficult to apply those things universally. Too busy to...

I don't have much interest in food, and I have criticized that I am only interested in taking medicine. I feel sorry that it is a bit overwhelming to provide detailed nutritional counseling now that the consultation time is not long. However, doctors are also very interested in food, and I will ask again how to express it. We are sorry that we are too busy to have time to study the latest truths. Some have criticized that we are too busy during consultation hours to even have time to study. We are studying hard to provide rational and applicable treatments in the domestic field. Among the activities of the teachers, there is an activity called an academic conference, which is a concept of gathering together to study. As for the DASH diet, as I mentioned earlier, it is about consuming less sodium and more magnesium for proper research results.

It means that it's okay to eat a lot of salt. Even if you don't eat breakfast today, if you don't eat kimchi, vegetables, or meat, essential nutrients may be severely lacking, leading to bigger health problems. The so-called 대출식단 (low salt diet) is a diet developed in the United States, focusing on how to lower blood pressure through diet alone for hypertensive patients. As you mentioned, it mainly consists of three elements: vegetables, nuts, and whole grains. The reason why the 대수식단 (low salt diet) became famous is that they directly provided meals to patients. Instead of just giving instructions like do this, they provided meals directly to see how blood pressure changes. The standard for a low-salt diet is based on a sodium intake of 2.3g.

In terms of salt, it is roughly equivalent to about 5 grams. This standard was established based on the average salt content provided in the DASH diet, which is about 5 grams. The reason for this decision is that patients who have meals based on the DASH diet have shown a clear decrease in blood pressure even without additional medication. Therefore, low-salt diets like the DASH diet are recommended. Despite following a low-salt diet in the DASH diet, efforts were made to ensure that other nutrients such as minerals, trace elements, and proteins are not lacking. In addition, specific cooking methods are introduced to address the concern that reducing salt may lead to a lack of taste. It is pointed out that using pepper or other spices can be a good alternative when salt is reduced, as this may be the biggest challenge for many people who feel that food lacks taste without salt. Detailed methods of using other seasonings are also provided, so those who are interested can take this opportunity to learn more.

If you look for a Dash diet, you might be able to apply it well. When it comes to ways to consume a lot of potassium, you mentioned bananas. Bananas are indeed a fruit rich in potassium and fiber, which can also be helpful for bowel movements. However, when dealing with nutrition-related matters, it is always important to be cautious. People who have shown good results have not just eaten bananas like the person you mentioned. In fact, based on the results that have shown good outcomes in nutrition studies, it would be more objective to emphasize that people who had a slightly higher ratio of potassium within a well-balanced diet showed good results. Consuming potassium in a refined form can be very dangerous because it can cause significant gastrointestinal disorders.

It's a completely different story to directly consume synthesized compounds by supplementing with food ingredients that can also cause ulcers. Secondly, it is a very risky suggestion to say that you should consume refined potassium in health supplements, as it is still medically incorrect. So, you should not follow that advice. Feel free to enjoy salty foods like kimchi stew and ramen, and instead, make sure to intake potassium well. In most cases, your kidneys can function well without any issues for a long time. This has been Dr. Geon's TV. Saying that it's okay to eat a lot of potassium at the same time has a few problems. There is a term in nutrition called Nutritivism. As I mentioned earlier, just because a specific diet has shown healthy results, thinking that supplementing with the elements included in that specific diet will be helpful may seem logical, but it does not necessarily

Food, in addition to those elements, also contains fiber or various elements such as millet. Recently, there has been talk about intestinal microbes. Because it is a complex entity where various elements gather, it seems appropriate to interpret food as food. Medically, what habits are recommended to help kidney health? What is lacking in modern people is not so much the impact as the fact that it is the amount of exercise. Regular exercise is a key factor in maintaining kidney health. One of the main causes of kidney damage is now diabetes. Therefore, it is important to manage blood sugar well and even if you have a disorder, it is important to exercise regularly to make up for the lack of exercise. Avoiding nephrotoxic drugs is also important. These are the two things that I can mention.

Yes, how was it? Did it help a lot? I hope you take good care of your kidney health and maintain a healthy life. Thank you. 

Yes, how was it? Did it help a lot? I hope you take good care of your kidney health and maintain a healthy life. Thank you.

저염식 힘들게 하는 대신 이것만 먹으면 신장이 살아난다!? [유사의학 vs 분당서울대병원]

세계 의료의 표준을 선도하는 국민의 병원, 분당서울대학교병원입니다.
Lead the Standard, Build the Trust, Seoul National University Bundang Hospital!

분당서울대학교병원

신장 건강에 대한 잘못된 상식 바로잡기

신장 질환의 종류에 따라 다양한 치료 방법이 있으며, 많은 경우 신장 기능의 회복이 가능합니다.

신체 활동과 약물 치료도 중요하기 때문에 신장 건강을 위해 식단만 강조하는 것은 편향적일 수 있습니다.

저염식 식단의 효과와 신장 건강에 대한 칼륨의 중요성은 최근의 과학적 증거에 의해 뒷받침되고 있으며, 오래된 믿음을 무너뜨리고 있습니다.

칼륨 보충제의 장기적인 사망률 감소는 역학적으로 연관성이 있지만 메커니즘이 확인되지 않았습니다.

중증 신장 질환 환자의 경우 음식을 통해 신체 건강을 유지하는 근본적인 접근 방식은 잘 알려져 있지 않습니다.

특히 신장 기능이 손상된 환자의 경우 칼륨을 많이 섭취하면 고칼륨혈증을 유발할 수 있으므로 임상에서는 보수적으로 접근합니다.

고혈압 치료에서 DASH 식단의 중요성

DASH 식단은 나트륨 섭취를 줄이고 마그네슘을 늘려 혈압을 낮추는 데 초점을 맞춘 식단으로, 연구 결과 혈압을 낮추는 데 효과가 있다는 것이 입증되었습니다.

환자에게 직접 식사를 제공하는 것으로 명성을 얻었으며 약물 없이도 혈압을 효과적으로 낮추는 것으로 나타났습니다.

이 식단은 또한 잠재적인 영양소 결핍에 대한 우려를 해결하고 소금 섭취 감소를 보완할 수 있는 대체 조미료 방법을 제공합니다.

균형 잡힌 식단에서 칼륨의 중요성

바나나와 같이 칼륨이 풍부한 식품을 많이 섭취하면 배변 활동에 도움이 될 수 있지만, 균형 잡힌 식단의 일부로 칼륨을 섭취하는 것이 필수적입니다.

정제된 칼륨을 섭취하거나 건강 보조제로 칼륨을 섭취하는 것은 위험할 수 있으며 위장 장애를 유발할 수 있습니다.

정제된 칼륨을 많이 섭취하라는 조언을 따르는 것은 위험하므로 자연 식품에서 칼륨을 섭취하는 데 집중하는 것이 좋습니다.

신장 건강을 위한 운동과 혈당 관리의 중요성

음식은 신장 건강을 포함한 전반적인 건강에 중요한 역할을 하며, 식단의 일부로 섬유질과 기장에 집중하는 것이 중요합니다.

규칙적인 운동은 특히 당뇨병이 신장 손상에 미치는 영향을 고려할 때 신장 건강을 유지하는 데 권장되는 핵심 습관입니다.

혈당 수치를 관리하고 신독성 약물을 피하는 것도 신장 건강을 위해 필수적입니다.