Page 46 - FoodFocusThailand No.234 September 2025

SPECIAL FOCUS

All of this data highlights the escalating severity of the Medical foods designed for patients with chronic kidney
CKD burden, which not only negatively affects patients’ disease undergoing hemodialysis are classified as foods
quality of life but also places an unavoidable strain on the for special medical purposes. According to the Ministry of
public health system. Therefore, it is essential to promote Public Health Notification No. 238 B.E. 2544 (2001), dated
comprehensive measures for prevention, screening, treatment, September 11, 2001, regarding foods for special medical
and rehabilitation, along with effective nutritional management purposes, these are defined as foods that are specially
to slow disease progression and reduce the burden of end- formulated or processed using specific recipes or ingredients
stage renal disease. to meet the special dietary needs arising from physical or
physiological conditions, illnesses, or bodily disorders. These
Medical Foods for Patients Undergoing foods differ significantly in nature, form, or composition from
Hemodialysis similar foods consumed under normal circumstances. The
End-stage chronic kidney disease patients receiving renal regulation classifies such foods into two main categories:
replacement therapy through hemodialysis have distinct 1) Foods for individuals with specific diseases or
nutritional requirements compared to those at earlier stages physical disorders: These are foods specially formulated
of the disease. This is due to significant nutrient loss during to meet the specific nutritional requirements of individuals
dialysis, dietary restrictions, disease-related side effects, whose needs are affected by diseases or physical disorders.
and metabolic complications. Therefore, the development of Their key characteristics include:
medical foods for this patient group must consider appropriate • Special formula or composition: Specifically designed
nutritional values in accordance with recommendations from or modified to suit the nutritional needs of particular disease
relevant professional organizations to effectively meet patient conditions, such as by increasing or decreasing certain
needs. nutrients, or adjusting the types of protein, carbohydrates,
1. Energy: Patients undergoing hemodialysis should or fats.
receive 30–35 kilocalories per kilogram of body weight per day • Different nutrient content: May contain adjusted levels of
to compensate for energy loss and prevent chronic malnutrition. energy, protein, vitamins, minerals, or fiber to appropriately
Energy intake may be increased using low-glycemic-index meet or restrict the patient’s needs.
carbohydrates or healthy fats that do not adversely affect blood • Modified physical characteristics: For example,
glucose or lipid levels. provided in liquid, semi-liquid, or powdered form to facilitate
2. Protein: Since hemodialysis results in significant loss consumption for patients with chewing or swallowing
of amino acids, patients are advised to consume 1.0–1.2 difficulties.
grams of protein per kilogram of body weight per day. The • Medical indication: Intended for use under specific health
protein should be of high biological value, easy to digest, and conditions and based on medical advice.
low in phosphorus to support muscle mass maintenance and Examples of foods for individuals with specific diseases
compensate for losses during dialysis. or physical disorders include:
3. Fat: The intake of unsaturated fats, such as omega-3 • Renal-specific formulas with restricted protein,
fatty acids, should be encouraged to help reduce inflammation potassium, and phosphorus
and prevent cardiovascular disease, which is common among • Diabetic-specific formulas with controlled sugar and
kidney disease patients. carbohydrate content
4. Minerals and Electrolytes: Patients on hemodialysis • Formulas for patients with impaired digestion or
must control their intake of various minerals, including: absorption, such as elemental or semi-elemental diets
• Sodium: 2,000–2,300 mg/day • Medical nutrition supplements for patients with
• Potassium: 2,000–2,500 mg/day malnutrition
• Phosphorus: 800–1,000 mg/day • Allergen-free foods, such as gluten-free or lactose-free
• Calcium: not exceeding 2,000–2,300 mg/day formulas
5. Fluid Intake: It is recommended to limit total daily fluid 2) Foods for individuals with special dietary
intake to prevent fluid overload and associated complications. purposes, such as those aiming to manage body weight,
elderly individuals, pregnant women, etc.
Medical foods for dialysis patients play an essential role
in supporting appropriate nutrition, reducing complications,
and improving long-term quality of life. The formulation
of these products must be carefully balanced in terms of
energy, protein, fat, minerals, and electrolytes, and must
be administered under the guidance of a medical team
and nutritionists. This ensures that the unique needs of
each patient are met and that optimal health outcomes are
achieved over the long term.

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