Diet and Kidney

People look at food labels for different reasons. Living with chronic kidney disease makes it even more important to look at food labels. The following label-building skills are intended to make it easier for you to use nutrition labels to make quick, informed food choices that contribute to a healthy diet.

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What is Sodium?

It is a mineral found in salt (sodium chloride), and is used in cooking and medicine. Lowering salt intake is important in certain medical conditions including high blood pressure, heart disease, chronic kidney disease and kidney stones.

What is the benefit of lowering sodium Intake?

– Lowering blood pressure (BP) if you have high BP

– Reducing risk of dying from a stroke

– Reversal of heart enlargement

– Reducing risk of kidney stones and osteoporosis.

How Do I limit my sodium intake?

– No salt shaker!

– Reduce or eliminate salt in cooking.

– Salts subs contain potassium. Check with your doctor if they are safe for you.

– Try herbs, spices, garlic, onions, or lemon instead.

– Read Labels! Avoid foods that have more than 300mg sodium per serving (or 600mg for a complete frozen dinner).

– Canned, bottled, “instant”, premixed, processed and frozen foods are usually high in salt. Rinse canned foods; but even better, eat fresh!

– As a general rule, 2300 mg of sodium a day or less is a good target. Look for “no salt added” foods.

– Dining out? Request the food be prepared without salt, have dressings or sauces on the side, and avoid bacon bits, cheese, and croutons at the salad bar.

– Avoid fast food restaurants!

– Reduce portion size.

– Read about The DASH diet (Dietary Approaches to Stop Hypertension).

– Water softeners remove calcium and add sodium to drinking water. Do not drink softened water.

– Don’t fall for it! Table Salt, sea salt, kosher salt all contain the same chemical product sodium chloride (NaCl). Sodium bicarbonate known as baking soda has sodium too, but is only used in certain medical conditions.

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What is Potassium?

Potassium is a mineral involved in how body muscles and nerves work and plays a role in keeping your heartbeat regular. When kidneys do not function properly, potassium builds up in the blood. This can cause changes in how the heart beats, possibly even leading to serious heart complications, including heart attack or arrest.

What Foods are high in Potassium?

Potassium-rich foods to avoid:

·        Melons such as cantaloupe and honeydew (watermelon is okay)

·        Bananas

·        Oranges and orange juice

·        Grapefruit juice

·        Prune juice

·        Tomatoes, tomato sauce, tomato juice and tomato paste

·        Dried beans – all kinds

·        Pumpkin

·        Winter squash

·        Cooked greens, spinach, kale, collards, Swiss Chard

·        Bran cereals and granolas

·        “salt substitute” or “lite” salt

·        Nuts and seeds

How to reduce potassium Intake?

·        Make sure to read nutrition fact labels.

·        A potassium restricted diet contains 2000mg of potassium daily. Ask your doctor and/pr dietician for the specifics of potassium restriction.

·        Look at the table below for different kinds of foods and potassium content in each.

·        Leach your vegetables, including potatoes and sweet potatoes. First, you peel them, cut them in small slices or cubes and soak them for several hours in a large amount of water. When you are ready to cook them, pour the soaking water off and use a large amount of water in the pan. Drain this water before you prepare them to eat. Your still need to limit the amounts.

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What is phosphorus and why is it important?

Phosphorus and calcium are minerals that helps build strong bones. High phosphorus is a common finding in people with chronic kidney disease, and can cause bone disease. It can also build up in different parts of the body like arteries, muscles, eyes, and under the skin causing all sorts of complications.

How do I keep my phosphorus level within normal limit?

A normal phosphorus level is between 2.5 and 4.5. To keep phosphorus from rising above that level you need to do the following steps:

·         Limit foods that are high in phosphorus, like dairy products, beans, nuts and dark-colored beverages.  See list below

·         Phosphate additives are commonly found in processed food. Read food ingredients and look out for words like phosphorus or phosphate

·         A phosphate binder is a pill taken around meal time and works by binding to or soaking up phosphorus in food during digestion. Then the binder and phosphorus are removed through bowel movements.

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When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.

Eat small portions of protein foods.
Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.

If you are on dialysis, you need to eat more protein, Renal dietitians encourage most people on hemodialysis to eat high-quality protein because it produces less waste for removal during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. Avoid processed meats such as hot dogs and canned chili, which have high amounts of sodium and phosphorus.

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Renal diet is a diet limited in a number of nutrients, like sodium, potassium and phosphorus. Dietary limitation of those nutrients depends on several factors including:

  • The current stage of kidney stage
  • Blood pressure control
  • Heart disease and volume control
  • Potassium and phosphorus levels

The following table provides a general guide. It places all these nutrients side by side for easy comparison.  Grading level (low-high-very high) given to each nutient is based on several assumptions including:

  • Daily Sodium limit of 2000 mg
  • Daily Potassium limit of 2000 mg
  • Daily phosphorus limit of 1000 mg
  • Daily protein intake of 0.8 g/kg of 70 kg male. Protein limitation does not apply to patients on dialysis.

These assumptions might not apply to individual patients. Every patient should seek medical and dietetary help for more specific advice.

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Nutrition and physical activity are important parts of a healthy lifestyle when you have diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood sugar level  in your target range. To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends.

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Drinking enough liquid, mainly water, is the most important thing you can do to prevent kidney stones. Unless you have kidney failure, many health care professionals recommend that you drink six to eight, 8-ounce glasses a day. Talk with a health care professional about how much liquid you should drink.

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To Learn more about kidney disease, so you can feel more in charge of your health and thrive, you can take a Kidney Care Education Class. The class covers:

  1. Symptoms and stages of chronic kidney disease (CKD)
  2. Eating well with kidney disease
  3. Coping and getting support

Other Educational Resources:

National Kidney Disease Education Program

American Kidney Fund

UpToDate For Patients

Renal Research Institute

Polycystic Kidney disease Foundation

National Kidney Foundation

Did you know?

 

%

of people in the US are estimated to have CKD

%

of new cases of CKD are caused by Diabetes

%

of new cases of CKD are caused by Hypertension

CKD: Chronic Kidney Disease.  Hypertension: High Blood Pressure. See Glossary of Terms. Source: CDC CKD fact sheet 2017