I Have Kidney Disease, What Can I Eat?
If you have been told by your doctor that you have chronic kidney disease (CKD), you may be wondering how to prevent further progression of the disease. One of the best ways to prevent the decline of kidney function is to make a serious commitment to following an evidence-based renal diet. Your best move to make is to schedule an appointment with a registered dietitian to receive individualized medical nutrition therapy, but there are some basic diet changes that every kidney patient should consider.
Decreasing sodium in your diet is the most important change you can make when you have been diagnosed with kidney disease. High blood pressure is one of the leading causes of CKD. Not only that, but your kidneys play a large role in controlling your blood pressure, and when they start to fail, you may have more difficulty keeping blood pressure in the normal range. Excessive sodium intake leads to fluid retention and high blood pressure and damages the kidneys. The American Heart Association recommends no more than 1500mg sodium per day for everyone. This low level of sodium intake is impossible to achieve if you are eating out at all. In order to meet this recommendation you would need to eat every meal at home made from scratch with no prepared or pre-packaged foods.
Since meeting this recommendation is so difficult while maintaining adequate calorie intake, in the real world, dietitians usually recommend less than 2000mg of sodium per day while eliminating as many processed foods, restaurant and fast foods as possible.
Think fresh! Try to eat as many meals as possible made from fresh meats, vegetarian protein sources, and fresh or frozen fruits and vegetables. If you do buy a food with a nutrition label, read it! If it is a whole meal, it should have less than 500mg of sodium. If it is a snack, it should have less than 200mg of sodium.
If your doctor tells you that your potassium level is high in your blood, you may need to decrease certain foods in your diet. These foods are not generally “unhealthy” foods. For someone with intact kidneys, eating high potassium foods is healthful and helps control blood pressure. For someone with chronic kidney disease, eating high potassium foods could cause a dangerously high potassium level that could eventually stop the heart from beating. It is best to work with a dietitian on controlling potassium in your diet, but a good rule of thumb is to avoid eating more than ½ cup of any fruit or vegetable at a time.
Eat mostly low potassium vegetables and fruits so you can get your 5 servings for the day. Examples of high potassium foods to limit are: milk, chocolate, nuts and seeds, potatoes, avocadoes, bananas, tomatoes, melon, mangos, spinach, beans, oranges and orange juice. Examples of low potassium fruits and vegetables that may be eaten up to 2 and ½ cups per day are: grapes, berries, apples, green beans, summer squash, lettuce, cucumbers, and celery.
Phosphorus is yet another mineral that must be monitored after you have been diagnosed with kidney disease. Unfortunately, most people are unaware of the harmful effects excessive phosphorus intake can have on our bones, organs, veins and arteries. Processed and fast foods are loaded with inorganic phosphate additives. This type of phosphorus is highly absorbed into the bloodstream, which causes an influx of calcium into the blood leading to an imbalance of calcium and phosphorus levels in the bones. This causes weak bones and calcification of the veins and arteries, leading to heart disease. There is some evidence that this happens to people who do not have kidney disease as well as those with CKD.
Phosphorus is another reason to avoid processed and fast foods. Phosphorus is often added to fresh meats as well. It is insidious in our food supply and not always listed on labels. You will have to just do the best you can with this. You can avoid phosphate that is added to processed foods by reading the ingredients list and avoid any type of phosphate listed such as tricalcium phosphate, used in various foods such as cake mixes, pancake mixes, biscuit mixes, powdered beverage mixes and many other foods and phosphoric acid, used mostly in carbonated beverages such as colas. Basically, avoid any ingredient with a “-phos-” in the name.
Prior to needing dialysis, sometimes it will be recommended that patients decrease the amount of protein they eat in their diet. This is not recommended for everyone, especially if you are losing weight or are malnourished. Please check with a dietitian to see if you need to reduce your protein intake. It is okay to limit your meat intake to about 4-6 oz per day and to start eating at least 2-3 vegetarian meals per week at any stage of CKD. Generally you will need to replace the calories from the meat that you would normally eat, so add a little olive oil to your food or eat a little extra bread or rice. If you do not have any issues with blood sugar or diabetes, it is okay to eat hard candy or vanilla cookies for extra calories.
If you are on dialysis, you need to eat extra protein to replace losses that occur during your treatment. It is important to discuss the amount of protein that is right for you with your dietitian.
This is the very basic kidney, or renal, diet.
Key Words: chronic kidney disease, renal diet, kidney diet, high potassium, low potassium, low sodium, low phosphorus, high phosphorus, dietitian, renal dietitian, kidney nutrition, renal nutrition