NUTRITION

Renal or Kidney Diet

Eating well is a very important aspect in maintaining over-all kidney health. Whether you are a CKD patient or a patient new or maintained on dialysis, a kidney diet will be an essential part of your well-being. Not only will it help you feel better, it can also help you avoid complications of your renal disease such as fluid overload, high blood potassium, bone disease, and weight loss.

Because each patient is different, your kidney diet will have to be prescribed your kidney doctor and customized by a renal nutritionist or dietitian to fit your lifestyle. Some factors need to be considered when making a renal diet prescription. These include the:

  • Stage of your kidney disease
  • Your body mass index
  • Level of daily physical activity
  • Type of treatment you are on
  • Laboratory results, and the
  • Presence of other medical conditions

The purpose of this diet is to keep the levels of electrolytes, minerals, and fluid in your body balanced when you have chronic kidney disease or are on dialysis. People on dialysis need this special diet to limit the buildup of waste products in the body.

Limiting fluids between dialysis treatments is very important because most people on dialysis urinate very little. Without urination, fluid will build up in the body and cause too much fluid in the heart, lungs, and ankles.

Renal Diet Prescription Elements

  • Calories

Calories provide your body with energy. Some people on dialysis need to gain weight. You may need to find ways to add calories to your diet. Vegetable oils—like olive, canola, and safflower oils—are good sources of calories and do not contribute to problems controlling your cholesterol. They may, however, be of limited use to patients with chronic obstructive pulmonary disease (COPD) because digestion of oils produce more carbon dioxide which tend to be detrimental to patients with COPD. Hard candy, sugar, honey, jam, and jelly also provide calories and energy. If you have diabetes, however, be very careful about eating sweets. A dietitian’s guidance is especially important for people with diabetes.

  • Proteins

Before you were on dialysis, your doctor may have told you to follow a low-protein diet to preserve kidney function. But once you are started on dialysis you may have different nutritional priorities. Most people on dialysis are encouraged to eat as much high-quality protein as they can. Protein helps you keep muscle and repair tissue, but protein breaks down into urea (blood urea nitrogen, or BUN) in your body. Some sources of protein, called high-quality proteins, produce less waste than others. High-quality proteins come from meat, fish, poultry, and eggs. Getting most of your protein from these sources can reduce the amount of urea in your blood.

  • Fluids

Your dietitian will help you determine how much fluid to drink each day. Extra fluid can raise your blood pressure, make your heart work harder, and increase the stress of dialysis treatments. Remember that many foods—such as soup, ice cream, and fruits contain plenty of water. Ask your dietitian for tips on controlling your thirst.

  • Salt (Sodium)

Most canned foods and frozen dinners contain high amounts of sodium. Too much of it makes you thirsty, and when you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure. Try to eat fresh foods that are naturally low in sodium, and look for products labeled “low sodium.”

  • Potassium

The mineral potassium is found in many foods, especially fruits and vegetables. Potassium affects how steadily your heart beats, so eating foods with too much of it can be very dangerous to your heart. To control potassium levels in your blood, avoid foods like oranges, bananas, tomatoes, potatoes, and dried fruits. You can remove some of the potassium from potatoes and other vegetables by peeling and soaking them in a large container of water for several hours, then cooking them in fresh water.

  • Phosphorus

The mineral phosphorus can weaken your bones and make your skin itch if you consume too much. Control of phosphorus may be even more important than calcium itself in preventing bone disease and related complications. Foods like milk and cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus and should be avoided. You’ll probably need to take a phosphate binder with your food to control the phosphorus in your blood between dialysis sessions.

  • Supplements

Vitamins and minerals may be missing from your diet because you have to avoid so many foods. Dialysis also removes some vitamins from your body. Your doctor may prescribe a vitamin and mineral supplement designed specifically for people with kidney failure. Take your prescribed supplement after treatment on the days you have hemodialysis. Never take vitamins that you can buy off the store shelf, since they may contain vitamins or minerals that are harmful to you.