Diet And Kidney Failure

Kidney failure also called End- Stage Renal Disease (ESRD), is defined as the last stage of kidney disease. In this state, the kidneys have stopped working resulting in a need for dialysis or kidney transplant. In most cases, kidney failure is caused by health problems that have done damage to the kidneys over time. The most common causes of ESRD is diabetes and high blood pressure.

Kidneys have many functions in the body. They remove waste, control blood pressure, make red blood cells, keep your bones healthy, maintain a normal balance of water, salts, and minerals—such as sodium, calcium, phosphorus, and potassium—in your blood. In kidney failure, the kidneys are unable to perform these functions; therefore, the balance of water, salts and minerals is disturbed. It becomes extremely important to follow a strict diet. Your doctor and dietitian will help you create a diet plan that works best for you depending on your treatment of kidney failure. I will provide you with some quick, general guidelines to help you get started.

Potassium

Your body needs this mineral  to make your muscles work. Potassium is a mineral found in almost all foods. In case of kidney failure, the kidneys are unable to filter potassium properly. Having too much potassium can become dangerous resulting in hyperkalemia. With kidney failure, you need just the right amount of potassium (your doctor and dietitian will inform you of the amount you need). Typically a potassium restricted diet is 2000 milligrams. See image below for low potassium foods.

Phosphorus and Calcium

Phosphorus is a mineral needed in the body along with calcium to build healthy bones. When the kidneys are not working properly, phosphorus builds up in the body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak. High phosphorus and calcium can lead to dangerous deposits in blood vessels, lungs, eyes and heart. Your doctor and dietitian will help you determine the right amounts you need for both of these minerals. Your doctor will most likely provide you with a phosphorus binder to help pull phosphorus out of food which usually also helps to lower calcium levels.

Phosphorus is found in the natural form in protein-rich foods such as meats, poultry, fish, nuts, beans and dairy products. Phosphorus is also used as an additive to preserve food. Added phosphorus is found in foods such as fast foods, ready to eat foods, canned and bottled drinks, enhanced meats, and most processed foods. Phosphorus from food additives is completely absorbed. These additives have many different names. Always make sure to look at the nutrition labels when purchasing food. Some common phosphorus additives are:

• Dicalcium phosphate

• Disodium phosphate

• Monosodium phosphate

• Phosphoric acid

Calcium is naturally occurring in dairy products, salmon, canned sardines, beans and lentils, and some leafy greens. Calcium is also often added to foods; unfortunately, food labels aren’t required to list the calcium content. Foods that may have added calcium include processed or packaged foods such as cereals, crackers or breads; juices and powdered drink mixes; and milk substitutes such as soy or almond milk. Labels on food packages with added calcium may include something like this:

• Calcium enriched

• Calcium fortified

• Excellent source of calcium

• Good source of calcium

Sodium

We discussed sodium in previous posts about heart disease and osteoporosis. It contributes to blood pressure regulation and fluid balance in the body. In kidney disease, sodium is not properly excreted out of the body. Too much sodium can be harmful for people with kidney disease. Sodium buildup may raise blood pressure, increase the risk of swelling making you feel uncomfortable, and it may cause more damage to the kidneys. One of the most important things you can do is talk with your dietitian. He or she will help you determine the salt content in food and can provide you with low- sodium recipes.

Here are some general tips for managing sodium intake:

• Read all food labels-salt can be found in food that does not taste salty.

• Limit the amount of processed, frozen and canned foods in your diet.

• Beware of beverages that contain added salt like sports drinks.

• Be creative and season your foods with spices, herbs, lemon, garlic, ginger, vinegar and pepper.

Fluid

Having too much water in your body is dangerous for people with kidney disease. One of the main functions of the kidneys is to balance fluid in the body. If too much fluid builds up in your body, it can have harmful effects on your health, such as difficulty breathing and swelling. Your fluid intake will depend on residual function (amount of kidney function left). As stated previously, your doctor and dietitian will help you determine the amount of fluid you can have.

Tips to manage fluid overload:

• Track your fluid by using a container you can mark, a journal, or an app on your phone.

• Follow your fluid guidelines provided by your health professionals.

• Find ways to manage your thirst such as sugar-free hard candies, ice chips, or frozen grapes.

• Remember that fluid is present in foods such as soups, fruits such as watermelon, and Popsicles.

I hope you now have a brief picture of how crucial diet is in managing kidney disease. Although having a particular diet takes time and planning, it can be possible with the help of your medical team and online resources such as The National Kidney Foundation and Davita Kidney Care.