Our Kidney Health Forums on nutrition now come to you in the comfort of your home, via online streaming, you can now view Kidney Disease and Nutrition – Getting the most out of what you can eat!
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We hope you enjoy this vodcast, filmed at one of our Kidney Health Australia ‘Well on My Way' Forums. You will listen to a panel of experts answer questions from participants on many aspects of a renal diet, like - The importance of nutrition and CKD - Heart health and kidney disease - Exercise, nutrition and bone health - Renal diets: myths and misconceptions.
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The development of this online program, enables Kidney Health Australia to run forums for kidney patients across Australia providing contact to people in isolated regional and rural communities.
Nutrition is very important in maintaining a healthy lifestyle when diagnosed with kidney disease! Advice on nutrition needs to be personalised as it is based on individual kidney function. If you have already seen a dietician, the information below should not take the place of the diet that has been prescribed for you. Your renal doctor can refer you to a renal dietician who will design a specific diet for your needs.
Other resources of interest:
Nutrition and CKD - some basic facts
Helping your kidneys to control body chemistry by eating a sensible diet is an early and important form of treatment for kidney failure. Being careful about what you eat can reduce the amount of fluid and waste build-up and help you feel better. The following substances feature in renal diets: protein, sodium, potassium, phosphate, fluids, fats and carbohydrates.
Why is nutrition so important? When food is broken down in the stomach and intestines, waste is made. The kidneys remove the waste from the blood. If the kidneys are not working properly, the waste builds up in the bloodstream and you may feel weak, tired, and sick. The other balancing act the kidneys perform is the regulation of the body’s fluid balance. Some people with kidney disease may retain fluid, which leads to puffiness, swollen ankles, hands and feet and breathlessness.
Protein builds, repairs and maintains body tissue. It also helps to fight infections and heal wounds.e Urea is a waste product, which is formed when the body breaks down protein. Your eating plan should be designed to provide enough protein for your body without causing urea to overload the kidneys. Too little protein may cause:
- loss of muscle bulk and wasting
- weight loss
- lack of energy
Too much protein produces excess urea, which may cause:
- tiredness
- nausea and vomiting
- headaches
- a bad taste in the mouth
- bad breath
- poor memory and concentration
Foods high in protein include:
- meat
- chicken
- fish
- eggs
- cheese, milk and other dairy foods (yoghurt, cheese)
- nuts, seeds and legumes
Sodium (salt) affects the amount of fluid the body retains. Salt also increases thirst, which can lead to drinking more fluid than your kidneys can remove and fluid retention. Too much fluid may cause:
- high blood pressure
- swelling of ankles, feet, hands and puffiness under the eyes
- shortness of breath
The amount of salt in your diet may need to be reduced so ask your doctor and dietician for advice. Foods high in salt include:
- processed foods e.g. ham, sausage and luncheon meats
- fast food e.g. pizza, pies, hamburgers, sausage rolls
- salty snacks e.g. pretzels, chips, salted nuts
- sauces and pickles
- salted seasonings e.g. stock cubes, celery and vegetable salts
Beware of salt substitutes as some contain potassium instead of sodium.
Refer to New England Journal of Medicine publication (Volume 344:3-10 January 4, 2001 Number 1) 'Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet' which has been proven to help lower blood pressure. Or for less 'medical' outline from National Institutes for Health USA 'In Brief: Your guide to lowering your blood pressure with DASH'
Potassium is an essential mineral in the body, which helps nerve endings and muscles work well.However, if the level of potassium is too high or low in the blood, it can cause an irregular heartbeat. In fact, potassium levels outside the normal range may cause the heart to stop.
How much potassium can you have? This depends on your blood results as well as the amount of urine you are passing. Foods high in potassium include:
- dried fruit and fruit cake
- fruit and vegetable juices
- tomato pastes and purees
- tinned and homemade soup
- liqueurs, red wine, cider, stout, nuts and seeds
- bananas, avocados, apricots, rockmelons
- spinach mushrooms
- dried peas, beans, baked beans
- potatoes, potato crisps, pumpkin
- chocolates, cocoa, liquorice
- stone fruits
- high fibre breakfast cereals, unprocessed bran
A tip for reducing potassium intake - cut vegetables into small pieces, soak them in a large volume of water for 1-2 hours before cooking, drain and cook normally. Alternatively, boil them and drain off the water. Not all fruits and vegetables have the same amounts of potassium.Talk to your renal dietician about what diet is appropriate for you.
See Kidney Health Australia's publication Back on the Menu - a recipe book for a restricted low potassium diet.
Phosphate and calcium are minerals that help to keep your bones strong and healthy. When the kidneys are not working properly, high levels of phosphate accumulate in the blood. This can cause:
- itching
- painful joints
- weak and brittle bones
The amount of phosphate allowed depends on your blood test results. Foods high in phosphate include:
- cola-based soft drinks e.g. Coca Cola and Pepsi
- nuts, seeds and peanut butter
- dried peas and beans and baked beans
- processed bran cereals
- sardines and fish pastes
- cheese, milk and other dairy products
Your doctor may prescribe phosphate binders. These bind the phosphate in your food so that it will pass out of your body. It is important to take phosphate binders with your meals and snacks. Phosphate binders include:
- Caltrate
- Alutabs
- Mylanta
- Titrilac
- Nephrex
- Magmin
- RenaGel
Fluids As kidney function worsens, the body can retain fluid so some people may need to limit their fluid intake. The recommended fluid intake will depend on your urine output, fluid build-up and blood pressure. The usual allowance is the urine output plus 600mls. Fluids include:
- water and ice cubes
- tea, coffee, juices, milk and milk products
- gravy, sauces and soups
- ice cream, jelly, custard and yoghurt
Some tips for restricting fluids - sip small amounts throughout the day, use smaller cups and glasses, remember that foods containing fluids need to be included in your fluid allowance.
Fats and Carbohydrates Maintaining a healthy weight is important for everyone. If protein has been restricted in your diet, your energy and kilojoule requirements may need to be met by increasing the amount of fats (polyunsaturated and/or monounsaturated) and carbohydrates that you eat. Otherwise you will lose weight, which is undesirable.
If haemodialysis commences, your protein restriction will be lifted as some proteins are lost from the body during dialysis. As your feeling of well being and appetite improves, you will find it easier to incorporate a greater variety of foods to meet your requirements. The renal dietician can help you to plan a new diet to suit your individual needs.
Points to remember
- Your nutritional care plan needs to be personalised and based on your kidney function.
- It may be difficult to meet your vitamin requirements so your doctor may prescribe a supplement.
- Ask questions until you understand your diet.
- You may need to measure foods and fluids; for greater accuracy, measure with a cup or scale.
- Take your medication as prescribed.
- Organise regular reviews and follow-up with your renal dietician.
- Follow your trends in body weight, blood pressure and blood values.
- Inform your doctor or dietician if you are losing weight or have any concerns about your diet.
- Following your suggested nutritional care plan may not treat or cure your kidney problem but it could help you reduce some of the symptoms and hence improve your general feeling of well being.
If confused about advice provided by your dietician about your renal diet phone
- or for hearing impaired - TTY/Voice 133 677 | Speak & Listen(SSR) 1300 555 727 begin_of_the_skype_highlighting 1300 555 727 end_of_the_skype_highlighting
You may find these recommended weblinks valuable - if a link is not working email health@kidney.org.au
Consultation with your renal dietician is essential to personalise your dietary plan for your individual health profile.
Food composition, standards and guidelines to support a renal diet
Professional organisations
Updated 24 July 2010