Diet for kidney disease

Alternative names:

kidney disease - diet; renal disease - diet

Recommendations:

The amount of protein allowed in the diet is determined by checking the amount of protein (and protein metabolic wastes) in the person's blood. Laboratory tests may include chem-20, creatinine, albumin, and blood urea nitrogen. Low-protein diets may prevent or slow the progress of some kinds of kidney disease. The amount of protein the person can eat is based on how well the kidneys are functioning and the amount of protein needed to maintain good health. Dialysis and the type of dialysis also influence protein needs.

The sodium content of a person's daily intake is controlled. This helps in maintaining fluid balance in the body to avoid dehydration or fluid retention. Reduced amounts of sodium in the diet helps control high blood pressure and congestive heart failure.

The daily intake of potassium is also controlled. This helps prevent hypokalemia (a low level of potassium, rarely a problem for people with renal disease) as well as hyperkalemia (a high level of potassium, a common problem for people with renal disease).

The mineral phosphorus is often controlled in this particular diet. When the amount of phosphorus is decreased by the reduced intake of dairy products and other foods high in phosphorus, there is a need to provide calcium supplements to prevent bone disease. The amount of phosphorus in the diet is controlled by the use of phosphorus binders (medications that bind the phosphorus in the food and make them unavailable to the body).

During renal failure, the amount of urine the body produces is decreased. The recommended daily amount of fluid is based on the amount of urine produced in a 24-hour period. Other considerations are the amount of fluid retention present, the level of dietary sodium, the use of diuretics, and the presence or absence of congestive heart failure.

People with renal disease are more prone to cardiovascular (heart) disease, so a diet with most of the calories from complex carbohydrates is recommended. Calories from fats should be from monounsaturated and polyunsaturated fats. The daily calorie intake needs to be adequate to maintain the person's nutritional status at an optimal level and to prevent the breakdown of body tissue. The person's weight and protein status should be monitored regularly, even daily.

Vitamin supplementation is very individualized. It is dependent on the various dietary restrictions, the extent of renal failure, and dialysis. The requirements for the fat-soluble vitamins (A, D, E, and K) are usually met by the diet. Vitamin D may need to be supplemented; this is an individual medical decision. The intake of water-soluble vitamins is often inadequate, as several good food sources of water-soluble vitamins are restricted on this diet. There is also loss of water-soluble vitamins from dialysis, the cooking methods for leaching potassium, and altered metabolism of vitamins.

The minerals that are also monitored include calcium, iron and magnesium. The recommended supplementation of daily calcium is 1,000 to 1,500 milligrams per day. Iron supplementation is based on the person's need. Magnesium supplementation is not recommended, as it can cause an increase in the magnesium levels in a person with renal disease.

Note: not all people with kidney disease need dietary supplements.

A SAMPLE MENU

• breakfast
  • 1 medium-sized apple
  • 3/4 cup of dry cereal
  • 2 slices of whole-grain toast
  • 2 teaspoons of margarine
  • 1 tablespoon of jam
  • 1 poached egg
  • tea
  • 5 teaspoons of sugar
  • 1/2 cup of nondairy creamer

• lunch
  • 3/4 cup of low-sodium soup
  • 2 ounces of lean roast beef
  • 2 whole-wheat rolls
  • A green tossed salad, with sliced tomato
  • 1 cup of canned fruit salad
  • 4 tablespoons of salt-free salad dressing
  • 6 ounces of Kool aid

• dinner
  • 2 ounces of broiled poultry
  • 3/4 cup of steamed rice
  • 1/2 cup of cooked green beans
  • 1 whole-wheat roll
  • 4 tablespoons of margarine
  • A green tossed salad
  • 1 tablespoon of salt-free salad dressing
  • A baked pear with sugar syrup
  • 4 ounces of lemonade

Snacks recommended throughout the day:

• hard candy
• 1 or 2 lollipops
• chewing gum