With over 2000 Australians admitted into hospital every day with kidney disease, it’s a health problem worth paying attention to. Healthy eating patterns are associated with lower rates of death in people with Kidney disease (Kelly, 2016) as well as a delay in the progression of chronic kidney disease (Wai, 2016)
A renal diet is one of the more complex diet plans around merely because specific nutrient requirements vary depending on the stage of chronic kidney disease. Recently, it has been suggested that certain similar eating patterns to the Australian Healthy Eating Guidelines could be the best for optimizing kidney health in those with a kidney disease. For those with more complicated side effects, careful consideration of protein, phosphorous, sodium, potassium, fluid and total energy intake is needed. Be it early or end-stage kidney disease without the use of dialysis, working with an Accredited practising dietitian with experience in renal disease is essential. With the appropriate diet changes, progression towards end stage kidney failure and dialysis can be delayed.
So, here’s a brief rundown of the nutrients foods to include in a renal diet for chronic kidney disease sufferers.
Protein and Kidney Disease
While protein is essential for a healthy body, digestion of it creates the waste product, urea, in the bloodstream which the kidneys need to filter out and excrete it into the urine. While it’s still important to have in moderate quantities, too much protein in the diet places unnecessary pressure on poorly functioning kidneys. Increasing urea levels within the blood may lead to nausea, poor appetite and possibly itchy skin. Depending on the severity of chronic kidney disease, your dietitian may devise a plan that reduces your protein intake by recommending slightly smaller portions of high protein foods.
Have a chat with your doctor and dietitian about the potential to substitute animal proteins for plant-based proteins, as a healthier way to maintain your protein intake, but also looking after your kidneys.
Phosphorus
Reduced kidney function in kidney disease results in an impaired ability to regulate and get rid of excess phosphorus from the bloodstream. Too much phosphorus leads to calcium loss from the bones and increases the risk of osteoporosis. Other more noticeable symptoms may include itchiness. Phosphorous is in a wide-range of protein-containing foods, however, it’s phosphate additives that are really bad for the kidney. Look to restrict your intake of beer, cola, processed meat (bacon, ham, sliced chicken and devon). There are also ‘natural’ sources of phosphorous in the diet but it is best to chat to a renal dietitian as to whether these need to be avoided.
Sodium
Excessive sodium (aka salt) in the diet places additional stress on the kidneys. Table salt contains about 40% sodium, so avoiding adding salt to your foods during cooking or at the dinner table can be effective at reducing your sodium levels. However, over 80% of the salt in our diet comes from packet/canned/processed foods so it’s best to minimise your use of high sodium foods such as ham, corned beef, Vegemite, gravies, sauces, canned foods, cheese, soups, chips and savoury biscuits.
Fluid
As kidney disease progresses, so too does the body’s ability to regulate fluid balance. Tend-stage end stage kidney disease with a poor urine output may be required to limit fluid intake. Chat with your doctor regarding your daily fluid requirements and be aware that foods that contain high amounts of fluids, such as fruit and vegetables, need to be counted in the daily fluid tally.
Potassium
Normally, your kidneys excrete most of the excess dietary potassium (approx. 80-90%) to help maintain potassium balance. However, this process becomes compromised in kidney disease. Found in many of the foods we eat, potassium plays an essential role in muscle contraction and heart function. For this reason, if the kidney is unable to rid the body of high levels of potassium, this can result in a heart attack if not reduced quickly. While not everyone with chronic kidney disease needs to lower their potassium intake, (a low potassium diet may be detrimental for some people) it is worth chatting to your doctor and renal dietitian about whether you should be avoiding this important mineral. All fruits and vegetables contain potassium, but the particularly high potassium choices include bananas, apricots, dates, dried fruits, mangoes, oranges, pawpaws, potatoes, baked beans, broccoli, carrot, pumpkin, spinach, tomatoes, lentils, soups and fruit and vegetable juices. We can help make sure your diet is rich in fruit and vegetables, but also isn’t risking elevated potassium.
To get more help with protecting your kidneys, book an appointment with our dietitian below.
Dr Jaimon Kelly
Kidney Dietitian
My Nutrition Clinic Kidney Dietitian Dr Jaimon Kelly has a PhD in chronic kidney disease nutrition and has published over 78 publication and authored 2 book chapters on the topics of kidney and chronic disease management through nutrition. He is an experienced educator and is a Research Fellow at the University of Queensland and an Adjunct Assistant Professor at Bond University. Jaimon supervises dietetic student, for both clinic and research placements and delivers GP and nurse training, and public workshops.
