Jeffrey Salazar
If you have stage 3 chronic kidney disease (CKD), it's important to know what dietary and nutritional goals you should be setting. Following a kidney-friendly diet could help slow the progression of the disease and improve your quality of life. A kidney-friendly diet typically includes foods that are easy on your kidneys and limits other foods and fluids to prevent certain minerals from building up in your body. For instance, you should be limiting your sodium intake to less than 2,300 milligrams per day. You should also be eating small portions of protein-rich foods and limiting your potassium and phosphorus intake. The DASH diet, which is rich in fruits, vegetables, low-fat dairy, whole grains, fish, poultry, beans, seeds, and nuts, is also recommended for people with kidney disease.
| Characteristics | Values |
|---|---|
| Protein | Small portions of protein foods. The amount of protein depends on body size, activity level and health. |
| Sodium | Less than 2,300 milligrams of sodium each day. |
| Phosphorus | No more than 800 mg of phosphorus to reduce the risk of phosphorus building up in the blood. |
| Potassium | Usually not restricted unless lab tests show high levels. |
| Calories | Adequate calories to maintain desirable weight. |
| Fluids | Limit fluid intake to prevent fluid retention. |
| Unhealthy fats | Replace with poly- and monounsaturated fats from vegetable oil, canola oil and olive oil. |
| Vitamins | Avoid herbal supplements and vitamins without consulting a doctor. |
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What You'll Learn
Limit protein intake
Limiting protein intake is an important part of managing stage 3 kidney disease. While protein is essential for building muscle, healing, and staying healthy, too much protein can make the kidneys work harder and cause damage. This is because when the body uses protein, it produces waste, which the kidneys must then filter.
The recommended protein intake for stage 3 kidney disease is 0.55-0.6 grams of protein per day per kilogram of body weight for those without diabetes. For those with diabetes, the recommendation is 0.8-0.9 grams of protein per day per kilogram of body weight. However, it's important to note that everyone's needs are different, and factors such as body size, activity level, and overall health can affect how much protein is right for an individual. It is always best to consult with a doctor or dietitian to determine the appropriate amount and type of protein for your specific needs.
To limit protein intake, it is recommended to eat small portions of protein-rich foods. Animal sources of protein, such as meat, fish, and dairy, should be limited, as they tend to be higher in fat and saturated fat. Instead, opt for lean proteins, which are high in protein and low in fat, such as whole eggs and skinless chicken or turkey. Plant-based proteins, such as beans, nuts, and seeds, can also be a good source of protein for those with kidney disease.
In addition to limiting protein, it is important to manage blood pressure, glucose, and weight. This can be done through adhering to a kidney-friendly diet that includes limiting sodium intake, reducing unhealthy fats, and eating fresh, whole foods. It is also important to monitor phosphorus and potassium intake, as these minerals can build up in the body and cause health issues when kidney function is impaired.
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Reduce salt and sodium
When you have stage 3 chronic kidney disease (CKD), it is important to watch what you eat and drink because your kidneys cannot remove waste products as efficiently. A kidney-friendly eating plan can help you stay healthier and
Reducing salt and sodium is an important part of this. Salt is mostly made up of sodium, and your kidneys may struggle to keep the right balance of sodium and water in your body. This can lead to thirst, fluid weight gain, and
The recommended daily allowance for sodium for people with CKD varies from 750 mg to 2,400 mg. The National Kidney Foundation recommends that dietary sodium intake be limited to less than 2,400 mg per day in patients with CKD and hypertension. A more recent clinical practice guideline issued by Kidney Disease: Improving Global Outcomes recommends lowering sodium intake to less than 2,000 mg per day in patients with CKD.
To reduce your salt and sodium intake, you can:
- Cook with herbs and spices for flavor instead of salt.
- Look for pasta and other products without added salt or sodium, and don't salt your pasta water.
- Make your own chicken and vegetable stock, which can be frozen for later use.
- Make your own spice and herb mixture and put it in your salt shaker.
- Be wary of low-sodium products, as they may contain potassium chloride as a substitute, which could be harmful if you are on a restricted potassium diet.
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Control fluid intake
When living with stage 3 kidney disease, it is important to manage your diet to slow the progression of the disease and improve your quality of life. This includes controlling your fluid intake to maintain adequate kidney function and prevent fluid retention. Here are some guidelines to help you control your fluid intake:
- Recognize the Signs of Fluid Retention: Fluid retention occurs when there is too much fluid buildup in your body. Signs of fluid retention include sudden weight gain, shortness of breath, swelling in the feet, hands, or face, and high blood pressure. If you experience any of these symptoms, consult your doctor immediately.
- Limit Fluid Intake as Needed: While fluid restrictions may not be necessary for everyone with stage 3 kidney disease, it is important to monitor your fluid intake. For those without fluid restrictions, it is generally recommended to consume 2 liters of fluid for women and 3 liters for men daily. However, it is always best to consult with your doctor or a renal dietitian to determine the appropriate fluid intake for your specific situation.
- Adjust Intake Based on Treatment: The amount of fluid you should consume may also depend on the treatment you are receiving for your kidney disease. For example, if you are undergoing hemodialysis, limiting fluid intake is important to lower the risk of complications such as low blood pressure and cramping during treatments. On the other hand, peritoneal dialysis may allow for a more normal fluid intake, but monitoring sodium and sugar intake is crucial to control thirst and weight gain.
- Be Mindful of Sweating and Illness: Discuss any sweating caused by heat or exercise with your healthcare team, as this may impact your fluid needs. Additionally, if you experience an illness with fever, vomiting, or diarrhea, you may need to increase your fluid intake to stay hydrated.
- Monitor Weight and Blood Pressure: Keep track of your weight and blood pressure regularly. If you notice sudden weight gain or changes in blood pressure, consult your healthcare team. They can advise you on adjusting your fluid intake to maintain a healthy balance.
- Limit Salt Intake: Reducing your salt intake can help manage fluid retention. Salt increases thirst, so by consuming less salt, you can also better control your fluid intake.
Remember, the recommendations for fluid intake may vary from person to person, so it is essential to work closely with your doctor and dietitian to develop a personalized plan that considers your specific needs and circumstances.
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Limit potassium and phosphorus
Limiting potassium and phosphorus in your diet is important when managing stage 3 kidney disease. Potassium is a mineral that the body needs to make muscles work. While potassium is not usually restricted in stage 3 kidney disease, your doctor may recommend a low-potassium diet if lab tests show that your potassium levels are too high. You can reduce elevated potassium levels by limiting high-potassium foods such as avocados and bananas, as well as potassium chloride, which is found in salt substitutes and many low-sodium processed foods.
Phosphorus is another mineral that is important for building strong and healthy bones. When you have chronic kidney disease, your kidneys cannot remove phosphorus effectively, leading to a build-up in your blood. High phosphorus levels can cause calcium to be pulled from your bones, making them weak and increasing the risk of fractures. Additionally, high phosphorus and calcium levels can lead to dangerous calcium deposits in the blood vessels, lungs, eyes, and heart, which can increase the risk of heart attack, stroke, or even death.
To manage your phosphorus intake, it is recommended to limit processed foods that contain inorganic phosphorus-containing additives. These additives are often found in fast foods, ready-to-eat meals, canned and bottled drinks, enhanced meats, and most other processed foods. When checking ingredient lists, look for terms containing "PHOS" to identify phosphorus additives. It is also important to monitor your phosphorus intake from natural food sources, as phosphorus content is not always listed on nutrition labels.
Working with a registered dietitian is crucial in developing a meal plan that includes foods you enjoy while maintaining your kidney health. They can help you adjust your meal plan based on your lab test results for phosphorus and potassium levels. Additionally, your dietitian can provide guidance on portion sizes and choosing the right combination of protein foods.
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Eat fruits and vegetables
Eating fruits and vegetables is an important part of a kidney-friendly diet. However, it is important to note that the nutritional needs of every individual with kidney disease are unique and can change over time, depending on their kidney function and other factors. Therefore, it is always best to consult a doctor or dietitian for a personalised diet plan.
In general, people with kidney disease should aim for a well-balanced diet that provides the right amounts of protein, calories, vitamins, and minerals each day. This can help individuals with kidney disease stay healthy and feel their best.
When it comes to fruits and vegetables, it is recommended to consume fresh or frozen whole fruits instead of juice. Whole fruits provide dietary fibre, which is often missing in juice. Fibre helps slow down carbohydrate absorption, preventing spikes in blood sugar levels. Additionally, the fibre in whole fruits helps with satiety, making individuals less likely to consume additional snacks and reducing their overall calorie intake. It is important to be mindful of portion sizes, especially with smaller fruits like grapes and tangerines, as it is easy to overeat. Certain fruits, such as grapefruit, should be avoided if they interfere with medications.
For individuals with stage 3 chronic kidney disease (CKD), it is crucial to manage blood pressure, glucose, and weight. This can be achieved through a kidney-friendly diet that includes fruits and vegetables low in sodium, phosphorus, and potassium. Sodium intake should be limited to less than 2,300 milligrams per day, as high sodium intake can contribute to high blood pressure. Phosphorus intake should not exceed 800 mg per day to prevent it from pulling calcium from the bones, leading to weak and brittle bones. Potassium intake may need to be restricted if lab tests indicate elevated levels.
It is important to note that some canned fruits and vegetables may be high in sodium. Therefore, it is recommended to drain and rinse them before consumption. Additionally, preparing meals at home using fresh ingredients allows for better control over the sodium, phosphorus, and potassium content of the food.
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Frequently asked questions
A kidney-friendly diet is recommended for people with stage 3 kidney disease. This involves limiting your intake of sodium, potassium, and phosphorus, as well as controlling your fluid intake. Your dietitian will work with you to develop a meal plan that includes foods you enjoy while maintaining your kidney health.
Foods with high levels of phosphate or phosphate additives such as organ meats, whole-grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products, and chocolate should be limited. You should also avoid salt substitutes that contain potassium and choose canned and jarred foods that say "no salt added".
Yes, it is important to eat slowly and stop eating when you are full. It is also recommended to avoid eating while doing something else, such as watching TV or driving, as you may not realize how much you have eaten. It is crucial to work closely with your doctor and dietitian to determine your personal limits for these nutrients, which are usually based on lab results.
