Leena Watts
When it comes to kidney failure, a renal diet or kidney-friendly eating plan can help protect the kidneys from further damage and slow down the progression of the disease. This involves limiting certain foods and fluids to prevent a buildup of waste and fluid in the blood, which can cause high blood pressure, swelling, and heart failure. People with kidney disease should restrict sodium, potassium, phosphorus, and protein in their diet, as these nutrients can build up to high levels when the kidneys are not functioning properly. It is important to work with a registered dietitian to develop a meal plan that is tailored to individual needs and includes foods that are enjoyed, while also controlling blood pressure and blood sugar.
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What You'll Learn
Limit sodium, phosphorus, potassium and fluids
When suffering from kidney failure, it is important to limit sodium, phosphorus, potassium, and fluids in your diet. This is because, as kidney function decreases, the kidneys struggle to remove waste and fluid from the blood, leading to a buildup of these substances, which can cause serious health issues.
Sodium
A diet containing less than 2300 milligrams of sodium is recommended for those with kidney disease. This means avoiding prepared or packaged foods, "fast" foods, frozen dinners, and canned foods, as these tend to be high in sodium. Instead, opt for cooking meals from scratch, which allows you to control the ingredients and their quantities. Eating fresh foods and reading labels can help reduce sodium intake.
Phosphorus
As kidney function declines, phosphorus can accumulate in the blood, leading to a range of issues. High phosphorus levels can pull calcium from bones, weakening them and increasing the risk of fractures. It can also cause itchy skin and bone and joint pain. Phosphorus is often added to packaged foods, deli meats, and some fresh meat and poultry. Checking ingredient labels for "PHOS" can help identify added phosphorus and reduce consumption.
Potassium
Kidney damage can cause a buildup of potassium in the blood, leading to serious heart problems. It is important to monitor potassium levels and adjust your diet accordingly. Salt substitutes, canned fruits and vegetables, and certain medications can be high in potassium, so it is important to read labels and consult with a healthcare provider.
Fluids
Limiting fluid intake is crucial for some individuals with kidney disease to prevent fluid overload, which can lead to heart failure and lung issues. Those on hemodialysis may limit weight gain per treatment to no more than 2.2 pounds or 1 kilogram per day and should monitor blood pressure and daily weights. It is recommended to consume smaller amounts of fluid throughout the day and opt for alternatives like mouthwash or hard candies to reduce thirst.
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Control blood sugar
If you have diabetes, it is important to control your blood sugar to prevent further damage to your kidneys. High blood sugar, or hyperglycaemia, can cause damage to many parts of your body, especially the kidneys, heart, blood vessels, eyes, feet and nerves.
Diabetes happens when your body does not make enough insulin or cannot use insulin properly. Insulin is a hormone that controls how much sugar is in your blood. A high level of sugar in the blood can cause damage to the very small blood vessels in your kidneys. Over time, this can lead to kidney disease and kidney failure. When blood vessels are damaged, they don't work as well, and the kidneys become damaged, allowing albumin to pass through the filters and into the urine.
You can control your blood sugar through diet, exercise and, if needed, insulin or hypoglycaemic pills. Your doctor and dietitian can help you create an eating plan that helps control your blood sugar, while also limiting sodium, phosphorus, potassium and fluids. You can also ask your doctor to refer you to a diabetes educator who can work with you to better manage your diabetes.
It is important to be aware of the symptoms of low blood sugar, or hypoglycaemia, which can be dangerous. Your risk of low blood sugar is higher if you are on dialysis, especially if you have trouble eating, are often sick or have other digestive problems.
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Limit protein
Limiting protein is an important part of managing kidney disease. While protein is a key nutrient that gives the body energy and helps build and maintain muscle, bone, skin, connective tissue, internal organs, and blood, it can also be harmful to those with kidney problems. When the body uses protein, it produces waste that the kidneys must filter. This means that eating more protein than necessary can make the kidneys work harder and cause further damage.
People with kidney disease should, therefore, aim to consume moderate amounts of protein. A dietitian can help determine the right amount and sources of protein for an individual's needs. Portion sizes for protein-rich foods vary depending on the type of food. For example, a cooked portion of chicken, fish, or meat is around 2 to 3 ounces (about the size of a deck of cards), while a portion of dairy is 1/2 cup of milk or yogurt, or one slice of cheese.
It is important to note that having too little protein can also be detrimental to health. It may lead to malnutrition and cause the skin, hair, and nails to become weak. Therefore, it is crucial to maintain a balanced diet that includes a moderate amount of protein while also limiting other nutrients such as sodium, potassium, phosphorus, and fluids.
Some plant-based foods that are suitable for a low-protein diet include shiitake mushrooms, which are also a good source of B vitamins, copper, manganese, and selenium. Additionally, macadamia nuts are a good option for those with kidney problems, as they are lower in potassium and phosphorus compared to other nuts.
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Limit fat
While fat is one of the nutrients that give you energy, limiting fat in your diet is important for managing kidney failure. This is because too much fat can lead to weight gain and heart disease. People with chronic kidney disease (CKD) are at a higher risk of heart disease and should limit their fat intake.
To limit fat in your diet, you should choose healthier fats, such as olive oil, canola oil, corn oil, peanut oil, and safflower oil. These oils are healthy alternatives to saturated fats and trans fats, which can raise cholesterol levels and clog blood vessels. Saturated fats are usually found in animal products, such as red meat, poultry, and butter, while trans fats are often found in baked goods, fried foods, and hydrogenated vegetable oils like margarine and vegetable shortening.
When cooking, it is recommended to grill, broil, bake, roast, or stir-fry foods instead of deep-frying. Using non-stick cooking spray or a small amount of olive oil instead of butter can also help to reduce fat intake. Trimming fat from meat and removing the skin from poultry before eating can further reduce fat consumption.
In addition to limiting fat, it is important to work with a registered dietitian to develop a meal plan that includes a variety of nutrients while maintaining kidney health. This may include limiting sodium, phosphorus, potassium, and fluids in your diet, as well as choosing whole grains and healthy carbohydrates.
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Consume vitamins and supplements
Consuming vitamins and supplements is crucial for individuals with kidney failure to ensure they obtain the necessary nutrients to maintain their overall health. Here are some key considerations and recommendations for vitamin and supplement intake:
Vitamin D:
Vitamin D is essential for maintaining bone health and reducing inflammation. People with kidney disease often experience vitamin D deficiency due to their kidneys' reduced ability to convert it into its active form. Supplementing with vitamin D can help manage bone disorders and prevent cardiovascular complications. It is important to have your vitamin D levels regularly checked by a healthcare professional, as excess vitamin D can also cause problems.
B Vitamins:
B vitamins, particularly B6, B12, and folic acid, are crucial for energy production and play a role in preventing anemia, a common issue in kidney disease. Supplementing with B vitamins can help prevent deficiencies and the associated health risks. B vitamins are generally considered safe for people with kidney issues, but it is always best to consult a healthcare professional first.
Iron:
Iron is vital for producing red blood cells and preventing anemia. Iron supplements can help alleviate symptoms associated with anemia, such as fatigue and weakness. They typically come in pill form, but some individuals may require intravenous iron supplementation, especially those receiving dialysis.
Calcium:
Calcium is essential for bone health and proper muscle function. People with kidney disease may need calcium supplements to prevent bone loss and maintain heart health. However, it is important to monitor calcium intake, as excess calcium can lead to vascular calcification.
Omega-3 Fatty Acids:
Omega-3 fatty acids are healthy fats with anti-inflammatory properties, which can benefit the kidneys and reduce the risk of chronic kidney disease progression.
Probiotics:
Probiotics can be particularly beneficial for individuals with kidney disease, as they help reduce uremic toxins that accumulate in the blood when kidneys are not functioning properly. They also aid in reducing inflammation and oxidative stress, which are common issues in chronic kidney disease.
Vitamin C:
Vitamin C is a powerful antioxidant that supports immune function, collagen production, and tissue repair. However, there are conflicting recommendations regarding vitamin C for individuals with kidney issues. While some sources suggest it can be beneficial, others caution that large doses may cause a buildup of oxalate, leading to pain and other issues. It is crucial to consult a healthcare professional before taking vitamin C supplements to ensure safe dosage.
Herbal Supplements:
Herbal supplements should be approached with caution, as they may interact with prescription medications and affect their effectiveness. Always consult your healthcare provider before taking any herbal supplements, especially if you are on medication or have specific health considerations.
It is important to remember that the specific vitamins and supplements recommended for individuals with kidney failure can vary depending on their unique health needs and medical history. Consulting a healthcare professional or a renal dietitian is essential to determine the appropriate supplementation regimen.
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Frequently asked questions
If you have kidney disease, you may need to follow a special diet, known as a renal diet, to protect your kidneys from further damage. There is not one correct eating plan for everyone with kidney disease, and your diet may change over time depending on your kidney function and other factors. It's important to work with a registered dietitian to develop a meal plan that includes foods you enjoy while maintaining your kidney health.
You may need to limit your intake of sodium, phosphorus, potassium and fluids. Many packaged foods have added phosphorus, and salt substitutes can be very high in potassium. Deli meats and some fresh meat and poultry can also have added phosphorus. It's important to read ingredient labels and watch what you eat and drink because your kidneys cannot remove waste products as well as they should.
Protein is important for building and maintaining muscle, bone, skin, connective tissue, internal organs, and blood. However, eating more protein than you need may make your kidneys work harder because they have to remove the waste products of protein. It's important to eat moderate amounts of protein and choose the right combination of plant-based and animal-based protein foods.
Everyone needs some fat in their diet, but too much fat or the wrong kinds of fat may cause buildup in your blood vessels, heart, and kidneys. People with kidney disease are at higher risk of heart disease and should limit the amount of saturated and trans fats they consume.
Some good foods to include in a kidney-friendly diet are shiitake mushrooms, macadamia nuts, radishes, turnips, pineapple, and unsweetened cranberry juice. These foods are lower in potassium and phosphorus and provide other important nutrients.
