Diet Matters

Healthy kidneys get rid of the wastes that comes from food once the body has used all of the nutrition in it. When kidneys no longer work properly, it is often necessary to change the way a person eats.

The diet needed for kidney failure depends on several things:

• The kind of kidney disease
• The stage of kidney failure-early, middle, or late
• The kind of dialysis chosen
• Whether or not diabetes is also present
• Height and weight
• Activity level
• Amount of urine output

A Dietitian is trained to evaluate all of these components and make the diet specific to each individual.

Nutrients to Know

Although every person needs their own specific diet, there are several nutrients that all renal diets include. Some nutrients are more or less important depending on whether you are a hemodialysis patient or PD patient. In general, there are less dietary restrictions for PD patients.

The common nutrients are:

• Calcium and phosphorus
• Sodium
• Fluid
• Potassium
• Protein
• Calories

Learning to read labels and knowing which foods contain the largest amounts of these nutrients will help you follow the renal diet. Here is a closer look at these nutrients.

Calcium and phosphorus, in the right balance, work together in the body to keep your teeth and bones strong and a change in one can cause a change in the other. If the kidneys fail, phosphorus may build up in your blood. Less phosphorus must be eaten for meals and snacks. It is also usually necessary to take a phosphorus binder with meals and snacks. This is a medicine used to grab hold of the phosphorus in the food and keep it from getting into the blood. A high phosphorus level in the blood can cause many problems including itching, bone pain, brittle bones, muscle aches and heart damage. A calcium supplement may also be needed to keep your bones strong.

Sodium is found in the diet, most commonly, as salt. Limiting salt helps control blood pressure and fluid buildup. In addition to the salt shaker, there are other sources of high sodium foods such as processed meats including bacon, sausage and luncheon meats. Snack foods, canned foods and frozen prepared meals also contain large amounts of salt.

Fluids in the diet are beverages such as water, milk and juice as well as foods that melt at room temperature such as ice cream. Since the kidneys are making much less urine or no urine at all, fluids need to be limited. Limiting fluids helps control blood pressure and puts less strain on the heart, which has to pump that fluid throughout the body.

Potassium is a mineral present in many fruits and vegetables as well as in meat and dairy products. If your kidneys do not work well, potassium can build up in the blood. Too much or too little potassium in the diet can affect the muscles in the body, particularly the heart.

Protein is needed daily to build muscles, repair tissues, fight infection and replace the protein lost from dialysis. Protein is the nutrient most needed to prevent malnutrition. Protein is present in many food items, but the highest quality protein comes from beef, pork, poultry, seafood and eggs. Well-nourished patients do better on dialysis, get sick less often and live longer.

Calories are needed to supply energy and to maintain weight. Calories come from all the foods you eat, including proteins, carbohydrates and fat. Calories are a concern if weight is too low or too high. Sometimes special liquid supplements are needed to provide enough calories to maintain weight or regain lost weight. Weight loss diets, in certain cases, are a consideration when being overweight is affecting your health.

The renal diet can be challenging. Dietitians, with highly specialized training, are available to provide a personalized diet and give information on how to use this diet. For further information on the right diet for your individual needs, consult a Dietitian.

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